Fungal infection in the immunocompromised patient. Dr Kirsty Dodgson
|
|
- David Owens
- 5 years ago
- Views:
Transcription
1 Fungal infection in the immunocompromised patient Dr Kirsty Dodgson
2 Aims Discuss different types of fungi Overview of types of clinical infections Clinical Manifestations
3 Fungus Includes Moulds Aspergillus Fusarium Dematiaceaous moulds e.g. Exophiala Mucoraceous moulds e.g. Rhizopus Yeasts Candida Pneumocystis Cryptococcus
4 Epidemiology Moulds are everywhere We breathe them in constantly Soil, vegetation Warm moist humid environments Neutropenic diet tries to reduce risk Crisps Pepper
5
6 Candida albicans Most common species isolated from superficial sites and blood. Most pathogenic species. Sensitive to most antifungal agents.
7 Non-albicans Candida species Many different species, very heterogeneous. Generally: Increasing frequency- multifactorial explanation. Probably less pathogenic than C. albicans. Often more resistant than C. albicans.
8 Changing Epidemiology ing aggressive therapy, leads to more susceptible patients. Ageing population more susceptible patients Use of prophylactic fluconazole leads to decrease in susceptible sp (e.g. albicans) and replacement with resistant sp (e.g. glabrata).
9 Skin and mucosa Asymptomatic colonisation Cutaneous candidiasis Chronic mucocutaneous candidiasis Oesophagitis Onychomycosis Oropharyngeal candidiasis Vulvovaginitis
10 Oesophagitis
11 Thrush Assocoiated with decrease in normal flora Watch for recurrent cases If occur perform ID and susceptibilities
12 Invasive Candidiasis Candidaemia Intravascular Catheters Disseminated candidiasis
13 Hepatosplenic Candidiasis Within the four overlapping forms of invasive candidiasis, there is a distinct clinical picture that has been given a variety of names: Chronic Disseminated Candidiasis (CDC) Hepatosplenic Candidiasis, Hepatic Candidiasis and Granulomatous Hepatitis. However, the other terms are equally valid.
14 Interestingly this is a condition that affects almost exclusively patients undergoing remission induction chemotherapy or bone marrow transplantation for acute leukemia HS Candidiasis
15 HS Candidiasis Another remarkable aspect of this condition is that it manifests only on recovery from prolonged periods of neutropenia. The other near constant finding is one of a group of abdominal symptoms. Right upper quadrant tenderness, hepatomegaly, abdominal distension, nausea, vomiting and diarrhoea occur with variable frequency.
16 HS Candidiasis Liver Function Tests. One of the most consistent biochemical findings in hepatosplenic candidiasis is a marked elevation on serum alkaline phosphatase. White Blood Count. Another commonly reported finding among patients with CDC is rebound leukocytosis Unfortunately, these laboratory changes are very similar to those found in cases of GVHD and sepsisrelated cholestatic liver disease, thus confusing the diagnosis
17 Deep Organ Candidiasis Abdomen (Peritonitis) Peritoneal Dialysis-related Candida Peritonitis Gut-injury Related Candida Peritonitis Bone & Joint Candidiasis Candida Osteomyelitis Candida Arthritis Brain & Nerves (CNS candidiasis) Neurosurgery-related CNS candidiasis Eye (Endophthalmitis) Gallbladder (Biliary Candidiasis) Heart (Cardiac Candidiasis) Lung (Candida Pneumonia) Kidney & Bladder (Urinary Candidiasis) Fungus Balls in Urinary Tract Asymptomatic Funguria Liver & Spleen (Hepatosplenic Candidiasis) Pancreas (Pancreatic Candidiasis)
18 Pneumocystis Jiroveci Pneumonia Normal flora in healthy competent individuals Normally seen as a reactivation in immunocompromised patients Traditionally an AIDS defining illness but seen in any immunocompromised pt Haematology, oncology and solid organ transplant pts Previously Pneumocystis carinii (PCP)
19 PJP Main symptom, exertional dyspnoea Marked desaturation Its actually a fungus Send deep samples for PJP PCR Sputum not ideal but better than nothing BAL is the gold standard
20 PJP
21 PJP Rx Treat with Septrin HD Atovaquone suspension - However, oral atovaquone has limited and unpredictable bioavailability Dapsone with trimethoprim - dapsone is given intravenously or occasionally in nebulised form in the treatment of PCP. Clindamycin with primaquine (unlicensed use in the UK) Aerosolised pentamidine isetionate is no longer recommended because it is associated with increased frequency of relapse Must receive 21 days total treatment
22 Crytococcus Characteristic features: Yeast forms capsule (seen on india ink stain)
23 Cryptococcus neoformans
24 Cryptococcus 34 species in the genus C. neoformans only one of real importance though case reports of other sp causing disease. 2 varieties exist: C. neoformans var neoformans and var gattii
25 Cryptococcus var neoformans found worldwide pigeon droppings soil Serotypes A, D & AD var gattii Tropical and subtropical eucalyptus trees Serotypes B & C
26 Cryptococcus Disease Organism inhaled-usually no or mild symptoms. pneumonia rare even in immunocompromised Meningitis-strongly neurotropic often subacute onset in immunocompetent Immunocompromised-HIV, transplant
27 Cryptococcus Diagnosis Microscopy of CSF Culture-CSF, Blood Anitgen-Blood, CSF
28 Aspergillus Most common mould infection but not all mould infections are aspergillus Diagnostics are poor so clinical diagnosis is key Fungi are angioinvasive so blood/sputum are rarely positive even by PCR Consider B-Glucan and galactomannan based on local policy
29 Aspergillus
30 Gram Stain
31 Sites of Infection Categories Colonization Allergic bronchopulmonary aspergillosis Pulmonary aspergilloma Invasive aspergillosis Sites Involved Sinuses, lungs Sinuses, lungs Pre-existing lung cavity - Pulmonary aspergillosis 1 - CNS aspergillosis - Sinonasal aspergillosis - Osteomyelitis - Endophthalmitis - Endocarditis - Renal abscesses - Cutaneous Others - Cutaneous: burns, post surgical wounds, IV insertion sites, etc. - Otomycosis - Exogenous endophthalmitis - Allergic fungal sinusitis - Urinary tract fungus balls 1This is the most common site of primary invasive aspergillosis.
32 Aspergilloma Colonise pre-existing cavities May be excised as can erode through and cause haemoptysis
33 Invasive Apergillosis
34 Invasive Apergillosis
35
36 18 mo girl with leukaemia
37
38 Other Moulds Zygomycetes Causes mucormyosis Rhinocerebral mucor, high mortality Fusarium Disseminated infection
39
40
41 THE END
Common Fungi. Catherine Diamond MD MPH
Common Fungi Catherine Diamond MD MPH Birth Month and Day & Last Four Digits of Your Cell Phone # BEFORE: http://tinyurl.com/kvfy3ts AFTER: http://tinyurl.com/lc4dzwr Clinically Common Fungi Yeast Mold
More informationECMM Excellence Centers Quality Audit
ECMM Excellence Centers Quality Audit Person in charge: Department: Head of Department: Laboratory is accredited according to ISO 15189 (Medical Laboratories Requirements for quality and competence) Inspected
More informationFungal update. Liise-anne Pirofski, M.D. Albert Einstein College of Medicine
Liise-anne Pirofski, M.D. Albert Einstein College of Medicine Fungal update http://clicks.robertgenn.com/miss-potter.php http://letterfromhere.blogspot.com/2007/06/beatrix-potters-jog-trot-through.html
More informationHAEMATOLOGY ANTIFUNGAL POLICY
HAEMATOLOGY ANTIFUNGAL POLICY PROPHYLAXIS Primary Prophylaxis Patient Group Patients receiving intensive remissioninduction chemotherapy for Acute Leukaemia (excluding patients receiving vinca alkaloids)
More informationEpidemiology and ecology of fungal diseases
Epidemiology and ecology of fungal diseases Healthcare Focus on: - individual - diagnosis - treatment Public Health Focus on: - population - prevention The nature of fungi Kingdom Fungi (lat. fungus, -i)
More informationFungal Infections: Reporting. Marcie Tomblyn, MD, MS Associate Member, Moffitt Cancer Center
Fungal Infections: Management and Reporting Marcie Tomblyn, MD, MS Associate Member, Moffitt Cancer Center February 25, 2010 Objectives Review common fungal infections in HCT patients Review current available
More informationPulmonary Infections: Fungus. Part I: Background Information and Dimorphic Fungus. Part II: Opportunistic Yeast and Molds
Pulmonary Infections: Fungus Part I: Background Information and Dimorphic Fungus Part II: Opportunistic Yeast and Molds Howard J. Sachs, MD www.12daysinmarch.com Classification: Unicellular Budding Yeast,
More informationProphylaxis versus Diagnostics-driven approaches to treatment of Invasive fungal diseases. Y.L. Kwong Department of Medicine University of Hong Kong
Prophylaxis versus Diagnostics-driven approaches to treatment of Invasive fungal diseases Y.L. Kwong Department of Medicine University of Hong Kong Pathogenic yeast Candida Cryptococcus Trichosporon Pathogenic
More informationFungal biology. Fungal Infections. Fungal cell structure. Pathogenesis
Fungal Infections Once exotic and rare; now increasingly common Fungi are not virulent But they are good at taking advantage Opportunistic in many senses Fungal biology Eukaryotic (organized nucleus and
More informationIntroduction. Study of fungi called mycology.
Fungi Introduction Study of fungi called mycology. Some fungi are beneficial: ex a) Important in production of some foods, ex: cheeses, bread. b) Important in production of some antibiotics, ex: penicillin
More informationCondition First line Alternative Comments Candidemia Nonneutropenic adults
Recommendations for the treatment of candidiasis. Clinical Practice Guidelines for the Management of Candidiasis: 2009 Update by the Infectious Diseases Society of America. Condition First line Alternative
More informationTitle: Author: Speciality / Division: Directorate:
Antifungal guidelines for CANDIDIASIS INFECTIONS (Adults) Proven infection: Targeted antifungal therapy should be prescribed for: o Positive cultures from a sterile site with clinical or radiological abnormality
More informationFungal infections in ICU. Tang Swee Fong Department of Paediatrics Universiti Kebangsaan Malaysia
Fungal infections in ICU Tang Swee Fong Department of Paediatrics Universiti Kebangsaan Malaysia Epidemiology of invasive fungal infections - US +300% Martin GS, et al. N Engl J Med 2003;348:1546-1554
More informationFungal biology. Pathogenesis. Fungal cell structure. Fungal Infections MID 25 & 26. Eukaryotic (organized nucleus and cell structure) Non-motile
Fungal Infections Once exotic and rare; now increasingly common Fungi are not virulent But they are good at taking advantage Opportunistic in many senses Fungal biology Eukaryotic (organized nucleus and
More informationMycobacteria and fungal infections of the respiratory tract
Before you start: You must read the slides! The Dr. did not bother to explain them all Mycobacteria and fungal infections of the respiratory tract - TB is a global problem that the WHO is trying to combat.
More informationPathogens with Intermediate Virulence Dermatophytes opportunistic Pathogens
Pathogens with Intermediate Virulence Dermatophytes opportunistic Pathogens Cryptococcus neoformans Candida albicans Aspergillus species Pneumocystis carinii 1 Dermatophytes Named for derma skin Cause
More informationCase Studies in Fungal Infections and Antifungal Therapy
Case Studies in Fungal Infections and Antifungal Therapy Wayne L. Gold MD, FRCPC Annual Meeting of the Canadian Society of Internal Medicine November 4, 2017 Disclosures No financial disclosures or industry
More informationMANAGEMENT OF HOSPITAL-ACQUIRED FUNGAL INFECTIONS
MANAGEMENT OF HOSPITAL-ACQUIRED FUNGAL INFECTIONS Paul D. Holtom, MD Associate Professor of Medicine and Orthopaedics USC Keck School of Medicine Numbers of Cases of Sepsis in the United States, According
More informationManagement of fungal infection
Management of fungal infection HKDU symposium 17 th May 2015 Speaker: Dr. Thomas Chan MBBS (Hons), MRCP, FHKCP, FHKAM Synopsis Infection caused by fungus mycoses Skin infection by fungus is common in general
More informationRheem Totah, Office H172M, Ph Office hours MWF 11:30 12:20 or by arrangement
Rheem Totah, Office H172M, Ph 206-543-9481 rtotah@uw.edu Office hours MWF 11:30 12:20 or by arrangement Date/Time Topic Readings Mon March 26 Antifungal agents Foye s Chapter 40 Wed March 28 Antifungal
More informationResearch priorities in medical mycology
Research priorities in medical mycology David W. Denning National Aspergillosis Centre University Hospital of South Manchester The University of Manchester Agenda How many patients are there with serious
More informationASPERGILLOSIS IN THE NON-NEUTROPENIC HOST
ASPERGILLOSIS IN THE NON-NEUTROPENIC HOST Dr J Garbino University Hospital Geneva ASPERGILLOSIS IN THE NON-NEUTROPENIC HOST INTRODUCTION SWISS ASPERGILLOSIS SURVEY IN THE NON-NEUTROPENIC HOST Introduction
More informationPneumocystis. Pneumocystis BIOL Summer Introduction. Mycology. Introduction (cont.) Introduction (cont.)
Introduction Pneumocystis Disclaimer: This lecture slide presentation is intended solely for educational purposes. Many of the images contained herein are the property of the original owner, as indicated
More informationFungal Infection Post-Infusion Data
Fungal Infection Post-Infusion Data Registry Use Only Sequence Number: Date Received: CIBMTR Center Number: Event date: / / Visit: 100 day 6 months 1 year 2 years >2 years. Specify: CIBMTR Form 2146 revision
More informationWHICH ANTIFUNGAL AGENT IS THE CHOICE FOR SUSPECTED FUNGAL INFECTIONS?
WHICH ANTIFUNGAL AGENT IS THE CHOICE FOR SUSPECTED FUNGAL INFECTIONS? Assoc. Prof. Dr. Serkan SENER Acibadem University Medical School Department of Emergency Medicine, Istanbul Acibadem Ankara Hospital,
More informationOpportunistic Mycoses
CANDIDIASIS SOFYAN LUBIS DEPARTEMEN MIKROBIOLOGI FAK.KEDOKTERAN USU MEDAN 2009 Opportunistic Mycoses Opportunistic mycoses are fungal infections that do not normally cause disease in healthy people, but
More informationFungal Infections. Alessandro Diana November 22th 2007
Fungal Infections Alessandro Diana November 22th 2007 alessandro.diana@ne.ch Topics Aspergillosis Candidiasis Cryptococcosis Histoplasmosis Coccidioidomycosis Blastomyocosis Sporotrichosis Pneumocystis
More informationPAGL Inclusion Approved at January 2017 PGC
Guideline for the prophylaxis and treatment of fungal infections in Haematology patients 1. Introduction PAGL Inclusion Approved at January 2017 PGC Haematology, CHUGGS June 2016 This guideline sets out
More informationElements for a Public Summary. [Product Name] 40 mg/ml oral suspension. VI.2.1 Overview of disease epidemiology
VI.2 Elements for a Public Summary [Product Name] 40 mg/ml oral suspension VI.2.1 Overview of disease epidemiology Fungi (yeasts) are small organisms that feed by breaking down tissue. In humans, fungi
More informationFungal infections and critically ill adults
Martin Beed FRCA FFICM DM Richard Sherman MRCP FRCA FFICM Stephen Holden MSc FRCPath 1A02,2C03 Key points The incidence of fungal diseases in critically ill patients is thought to be increasing, most commonly
More informationVoriconazole October 2015 Risk Management Plan. Voriconazole
Voriconazole October 2015 VI.2 VI.2.1 Elements for a Public Summary Overview of disease epidemiology Invasive aspergillosis (IA) is the most devastating of Aspergillus related diseases, targeting severely
More informationIntroduction Medical Mycology. Prof. Dr. Asem Shehabi Faculty of Medicine University of Jordan
Introduction Medical Mycology Prof. Dr. Asem Shehabi Faculty of Medicine University of Jordan General Fungi-1 Medical Mycology deals with fungi cause human diseases directly (mycoses, allergies) or indirectly
More informationFungal Infection Pre-Infusion Data
Fungal Infection Pre-Infusion Data Registry Use Only Sequence Number: Date Received: CIBMTR Center Number: Event date: / / CIBMTR Form 2046 revision 5 (page 1 of 5). Last Updated May, 2018. Infection Episode
More informationFungi are eukaryotic With rigid cell walls composed largely of chitin rather than peptidoglycan (a characteristic component of most bacterial cell
Antifungal Drugs Fungal infections (Mycoses) Often chronic in nature. Mycotic infections may be superficial and involve only the skin (cutaneous mycoses extending into the epidermis) Others may penetrate
More informationCURRENT AND NEWER ANTI-FUNGAL THERAPIES- MECHANISMS, INDICATIONS, LIMITATIONS AND PROBLEMS. Dr AMIT RAODEO DM SEMINAR
CURRENT AND NEWER ANTI-FUNGAL THERAPIES- MECHANISMS, INDICATIONS, LIMITATIONS AND PROBLEMS Dr AMIT RAODEO DM SEMINAR Introduction The incidence of invasive fungal infections in critically ill intensive
More informationCandiduria in ICU : when and how to treat? Dr. Debashis Dhar Dept of Critical Care and Emergency Medicine Sir Ganga Ram Hospital
Candiduria in ICU : when and how to treat? Dr. Debashis Dhar Dept of Critical Care and Emergency Medicine Sir Ganga Ram Hospital Introduction Nosocomial bacteriuria or candiduria develops in up to 25%
More informationAntifungal Update 2/22/12. Which is the most appropriate initial empirical therapy in a candidemic patient?
Antifungal Update B. Joseph Guglielmo, Pharm.D. Professor and Chair Department of Clinical Pharmacy School of Pharmacy University of California San Francisco 3/3 blood cultures are positive for an unidentified
More informationAntimicrobial prophylaxis in liver transplant A multicenter survey endorsed by the European Liver and Intestine Transplant Association
Antimicrobial prophylaxis in liver transplant A multicenter survey endorsed by the European Liver and Intestine Transplant Association Els Vandecasteele, Jan De Waele, Dominique Vandijck, Stijn Blot, Dirk
More informationNeutropenic Sepsis Guideline
Neutropenic Sepsis Guideline Neutropenic Sepsis Guideline - definitions Suspected or proven infection in a neutropenic patient is a MEDICAL EMERGENCY and is an indication for immediate assessment and prompt
More informationFungal Infections. Fungal Infections
Fungal Infection in the Immune Competent Host Steven L. Primack, MD Fungal Infection in the Immune Competent Host Steven L. Primack, MD Department of Radiology Oregon Health & Science University Fungal
More informationCigna Drug and Biologic Coverage Policy
Cigna Drug and Biologic Coverage Policy Subject Voriconazole Effective Date... 3/15/2018 Next Review Date... 3/15/2019 Coverage Policy Number... 4004 Table of Contents Coverage Policy... 1 General Background...
More informationMycological Profile of Bronchial Wash Specimens in Patients with Lower Respiratory Tract Infections
International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 6 Number 11 (2017) pp. 176-182 Journal homepage: http://www.ijcmas.com Original Research Article https://doi.org/10.20546/ijcmas.2017.611.022
More informationTrust Guideline for the Use of Antifungals in Adults
For Use in: By: For: Division responsible for document: Key words: Name of document author: Job title of document author: Name of document author s Line Manager: Job title of author s Line Manager: Supported
More informationLethal pulmonary fungal disease think fungus early
Lethal pulmonary fungal disease think fungus early David W. Denning National Aspergillosis Centre University Hospital of South Manchester The University of Manchester Global Action Fund for Fungal Infections
More informationAntifungal Update. Candida: In Vitro Antifungal Susceptibility Testing
Antifungal Update B. Joseph Guglielmo, Pharm.D. Professor and Chair Department of Clinical Pharmacy School of Pharmacy University of California San Francisco The patient spikes a new fever and 3/3 blood
More informationADEQUATE ANTIFUNGAL USE FOR BLOODSTREAM INFECTIONS
ADEQUATE ANTIFUNGAL USE FOR BLOODSTREAM INFECTIONS COMMERCIAL RELATIONS DISCLOSURE 2500 9000 15000 Astellas Gilead Sciences Pfizer Inc Expert advice Speaker s bureau Speaker s bureau OUTLINE OF THE PRESENTATION
More informationHigh risk neutropenic patient (anticipated duration > 10 days) Send blood twice weekly for Beta -D Glucan Galactomanan Aspergillus PCR
DERBY TEACHING HOSPITALS NHS FOUNDATION TRUST Prophylaxis, diagnosis and treatment of invasive fungal infections in oncology/haematology patients with prolonged neutropenia. High risk neutropenic patient
More informationNationwide survey of treatment for pediatric patients with invasive fungal infections in Japan
J Infect Chemother (2013) 19:946 950 DOI 10.1007/s10156-013-0624-7 ORIGINAL ARTICLE Nationwide survey of treatment for pediatric patients with invasive fungal infections in Japan Masaaki Mori Received:
More informationLatest Press Release. Cloud9games.tk
corp@stantec.com Latest Press Release Cloud9games.tk S (Dorland, 27th ed); Infection with a fungus of the genus candida; usually a superficial infection of the moist areas of the body and is generally
More informationOPPORTUNISTIC MYCOSES
OPPORTUNISTIC MYCOSES Candida yeasts that is, fungi that exist predominantly in a unicellular form. small (4-6 µm), thin-walled, ovoid cells (blastospores) that reproduce by budding. do not require special
More informationUse of Antifungal Drugs in the Year 2006"
Use of Antifungal Drugs in the Year 2006" Jose G. Montoya, MD Associate Professor of Medicine Associate Chief for Clinical Affairs Division of Infectious Diseases Stanford University School of Medicine
More informationESCMID Online Lecture Library. by author. CASE PRESENTATION ECCMID clinical grand round May Anat Stern, MD Rambam medical center Haifa, Israel
CASE PRESENTATION ECCMID clinical grand round May 2014 Anat Stern, MD Rambam medical center Haifa, Israel An 18 years old Female, from Ukraine, diagnosed with acute lymphoblastic leukemia (ALL) in 2003.
More informationEMPIRICAL PRESCRIBING GUIDELINES FOR SYSTEMIC FUNGAL INFECTIONS IN ADULTS - HH (1)/CL(G)/651/13
Hampshire Hospitals NHS Foundation Trust Empirical Antifungal Prescribing Guidelines [INSERT UNIQUE POLICY IDENTIFIER] Due for latest review on January 2015. CHECK THE INTRANET FOR LATEST VERSION EMPIRICAL
More informationAntifungal Agents - Cresemba (isavuconazonium), Vfend. Prior Authorization Program Summary
Antifungal Agents - Cresemba (isavuconazonium), Noxafil (posaconazole), Vfend (voriconazole) Prior Authorization Program Summary FDA APPROVED INDICATIONS DOSAGE 1,2,14 Drug FDA Indication(s) Dosing Cresemba
More informationEMERGING FUNGAL INFECTIONS IN IMMUNOCOMPROMISED PATIENTS
EMERGING FUNGAL INFECTIONS IN IMMUNOCOMPROMISED PATIENTS DR LOW CHIAN YONG MBBS, MRCP(UK), MMed(Int Med), FAMS Consultant, Dept of Infectious Diseases, SGH Introduction The incidence of invasive fungal
More informationPROGRESSI NELLA TERAPIA ANTIFUNGINA. A tribute to Piero Martino
PROGRESSI NELLA TERAPIA ANTIFUNGINA A tribute to Piero Martino 1946-2007 ITALIAN ICONS IERI, OGGI, E DOMANI IERI, OGGI, E DOMANI IERI, OGGI, E DOMANI 1961 CAUSES OF DEATH IN PATIENTS WITH MALIGNANCIES
More informationAn Update in the Management of Candidiasis
An Update in the Management of Candidiasis Daniel B. Chastain, Pharm.D., AAHIVP Infectious Diseases Pharmacy Specialist Phoebe Putney Memorial Hospital Adjunct Clinical Assistant Professor UGA College
More informationAntifungal Update 2/24/11. Which is the most appropriate initial empirical therapy in a candidemic patient?
Antifungal Update B. Joseph Guglielmo, Pharm.D. Professor and Chair Department of Clinical Pharmacy School of Pharmacy University of California San Francisco The patient spikes a new fever and 3/3 blood
More informationAdvance laboratory diagnosis of fungal meningitis: A mini review
INT J CURR SCI 2013, 6: E 46-50 REVIEW ISSN 2250-1770 Advance laboratory diagnosis of fungal meningitis: A mini review *Biswajit Batabyal a, Bappa Mandal b, Dwaipayan Saha c and Sukanta Chakraborty d a
More informationUse of Antifungals in the Year 2008
Use of Antifungals in the Year 2008 Jose G. Montoya, MD Associate Professor of Medicine Associate Chief for Clinical Affairs Division of Infectious Diseases Stanford University School of Medicine Diagnosis
More informationFungal Meningitis. Stefan Zimmerli Institute for infectious diseases University of Bern Friedbühlstrasse Bern
Fungal Meningitis Stefan Zimmerli Institute for infectious diseases University of Bern Friedbühlstrasse 51 3010 Bern Death due to infectious diseases in sub-saharan Africa Park BJ. Et al AIDS 2009;23:525
More informationOutline NEW DIAGNOSTIC TOOLS WHY? WHICH TESTS? WHEN TO USE THEM? Documented IFI
New Developments and Challenges in Diagnostics of Invasive Fungal Infections O. Marchetti, MD Infectious Diseases Service, Department of Medicine, CHUV and University of Lausanne, Switzerland Workshop
More informationFungi GUIDE TO INFECTION CONTROL IN THE HOSPITAL CHAPTER NUMBER 53: Author Moi Lin Ling, MBBS, FRCPA, CPHQ, MBA
GUIDE TO INFECTION CONTROL IN THE HOSPITAL CHAPTER NUMBER 53: Fungi Author Moi Lin Ling, MBBS, FRCPA, CPHQ, MBA Chapter Editor Ziad A. Memish, MD, FRCPC, FACP Cover heading - Topic Outline Topic outline
More informationAntifungal drugs Dr. Raz Muhammed
Antifungal drugs 13. 12. 2018 Dr. Raz Muhammed 2. Flucytosine (5-FC) Is fungistatic Is a synthetic pyrimidine antimetabolite Is often used in combination with amphotericin B in the treatment of systemic
More informationCurrent options of antifungal therapy in invasive candidiasis
Current options of antifungal therapy in invasive candidiasis Saloua Ladeb Bone Marrow Transplant Center Tunis HAMMAMET 24 th April 2012 DEFINITION One or more positive results on blood culture for Candida
More informationCMV. Inclusions predominantly in endothelial cells. Immunostaining greater sensitivity than H&E alone.
CMV Inclusions predominantly in endothelial cells. Immunostaining greater sensitivity than H&E alone. CMV inclusions are often present in a very patchy distribution Carefully examine all levels CMV CMV
More informationFungi More or Less Obligately Associated with Humans. Requirements for Designating a Mycosis*
P Fungi More or Less Obligately Associated with Humans a. a few dermatophytes (the anthropophilic species ) b. Malassezia furfur c. Candida albicans d. + Lacazia (Loboa) loboi*p e. + Pneumocystis jirovecii*p
More informationFungal and Viral Infections
CHAPTER 89 Fungal and Viral Infections Palash Samanta, Ghady Haidar, Minh Ly Nguyen, Cornelius J. Clancy, and M. Hong Nguyen FUNGAL INFECTIONS Fungal Pathogens Medically relevant fungi are classically
More informationEpidemiology and Laboratory Diagnosis of Fungal Diseases
Medical Mycology (BIOL 4849) Summer 2007 Dr. Cooper Epidemiology of Mycoses Epidemiology and Laboratory Diagnosis of Fungal Diseases Mycosis (pl., mycoses) - an infection caused by a fungus Two broad categories
More informationStudy of systemic fungal infections in renal transplant recipients
Original Research Article Study of systemic fungal infections in renal transplant recipients N.D. Srinivasaprasad 1*, G. Chandramohan 1, M. Edwin Fernando 2 1 DM (Nephrology), Assistant Professor, 2 DM
More informationAntifungal prophylaxis in haematology patients: the role of voriconazole
REVIEW 10.1111/j.1469-0691.2012.03772.x Antifungal prophylaxis in haematology patients: the role of voriconazole Y. Hicheri 1, G. Cook 2 and C. Cordonnier 1 1) Service d Hématologie Clinique, Assistance
More informationSummary of the risk management plan (RMP) for Cresemba (isavuconazole)
EMA/576866/2015 Summary of the risk management plan (RMP) for Cresemba (isavuconazole) This is a summary of the risk management plan (RMP) for Cresemba, which details the measures to be taken in order
More informationFungal Infections in Neutropenic Hematological Disorders
Fungal Infections in Neutropenic Hematological Disorders 23 Dr Farah Jijina 24 Fungal Infections in Neutropenic Hematological Disorders 25 Dr Farah Jijina 26 Fungal Infections in Neutropenic Hematological
More informationFungi. Eucaryotic Rigid cell wall(chitin, glucan) Cell membrane ergosterol Unicellular, multicellular Classic fungus taxonomy:
MYCOLOGY Mycology I Fungi Eucaryotic Rigid cell wall(chitin, glucan) Cell membrane ergosterol Unicellular, multicellular Classic fungus taxonomy: Morphology Spore formation FFungi Yeast Mold Yeastlike
More informationIs pre-emptive therapy a realistic approach?
Is pre-emptive therapy a realistic approach? J Peter Donnelly PhD, FRCPath Department of Haematology Radboud University Nijmegen Medical Centre Nijmegen, The Netherlands Is pre-emptive therapy a realistic
More informationAntifungals and current treatment guidelines in pediatrics and neonatology
Dragana Janic Antifungals and current treatment guidelines in pediatrics and neonatology Dragana Janic. University Children`s Hospital, Belgrade, Serbia 10/10/17 Hotel Crowne Plaza, Belgrade, Serbia; www.dtfd.org
More informationHistopathology Description:
2013-2-1 CANINE HEART Ahmed M. Abubakar BOVINE PATHOLOGY CONTRIBUTING INSTITUTION : The Royal Veterinary college, Dept. of Pathology and Biology Signalment: 11-month-old male Border Collie dog (Canis familiaris)
More informationCryptococcus gattii Fungal Meningitis. By Cassy Hedberg BI 234
Cryptococcus gattii Fungal Meningitis By Cassy Hedberg BI 234 This disease s deadliest weapon is the fact you ve never heard of it -Kausik Datta, Post-doctoral Fellow at Johns Hopkins Medicine A deadly
More informationEpidemiology of Fungal Diseases
Lecture 2 Epidemiology of Fungal Diseases Disclaimer: This lecture slide presentation is intended solely for educational purposes. Many of the images contained herein are the property of the original owner,
More informationAntifungal therapies differences in agents
Antifungal therapies differences in agents The basic Fungi are eukaryotes Eukaryote = an organism whose cells contain complex structures enclosed within membrane. Most Common Fungal Pathogens Dermatophytes
More informationThe sensitivity of fungal microorganisms to fluconazole is as follows:
FLUCAN Composition Each capsule contains Fluconazole 50, 100 or 150 mg Capsules Action Fluconazole is a triazole anti-fungal, which in sensitive fungi, inhibits cytochrome P450-dependent enzymes resulting
More informationFever. National Pediatric Nighttime Curriculum Written by Debbie Sakai, M.D. Institution: Lucile Packard Children s Hospital
Fever National Pediatric Nighttime Curriculum Written by Debbie Sakai, M.D. Institution: Lucile Packard Children s Hospital Case 1 4-month-old well-appearing girl admitted for croup and respiratory distress.
More informationInvasive Fungal Infections in Solid Organ Transplant Recipients
Outlines Epidemiology Candidiasis Aspergillosis Invasive Fungal Infections in Solid Organ Transplant Recipients Hsin-Yun Sun, M.D. Division of Infectious Diseases Department of Internal Medicine National
More informationLondon New Drugs Group APC/DTC Briefing
London New Drugs Group APC/DTC Briefing Posaconazole for invasive fungal infections Contents Background 2 Dosing Information 3 Clinical evidence for treatment of infections 3 Clinical evidence for prophyactic
More informationHow to make a fast diagnosis
How to make a fast diagnosis 8 th Advances Against Aspergillosis 1 3 February 2018 Lisbon, Portugal Cornelia Lass-Flörl Division of Hygiene and Medical Microbiology Innsbruck Medical University Division
More informationGeneral History. 林陳 珠 Female 69 years old 住院期間 : ~ Chief Complaint : sudden loss of conscious 5 minutes in the morning.
General History 林陳 珠 Female 69 years old 住院期間 : 93.5.8~93.5.15 Chief Complaint : sudden loss of conscious for 2-52 5 minutes in the morning. General History DM under regular medical control for 10 years.
More informationCryptococcosis*,** *usually considered to be an opportunistic mycosis that often becomes systemic.
Cryptococcosis*,** Definition - a chronic, subacute or rarely acute pulmonary, systemic or meningitic infection caused by Cryptococcus neoformans - the encapsulated Blastomycetes anamorph of Filobasidiella
More informationFLUCAND HIKMA PHARMACEUTICALS
09-15 FLUCAND HIKMA PHARMACEUTICALS (Fluconazole) Description Flucand is a crystalline white - whitish powder, which is slightly soluble in water and in a saline solution. Its molecular weight is 306.3.
More informationVentilator Associated Pneumonia. ICU Fellowship Training Radboudumc
Ventilator Associated Pneumonia ICU Fellowship Training Radboudumc Attributable mortality VAP Meta-analysis of individual patient data from randomized prevention studies Attributable mortality mainly results
More information2/18/19. Case 1. Question
Case 1 Which of the following can present with granulomatous inflammation? A. Sarcoidosis B. Necrobiotic xanthogranulma C. Atypical mycobacterial infection D. Foreign Body Reaction E. All of the above
More informationDr Hamed Alzoubi. Fungal infections
Dr Hamed Alzoubi Fungal infections Skin & subcutaneous Mycoses 1-Superficial mycoses such as 2-Cutaneous mycoses such as 3-Subcutaneous mycoses Tinea versicolor or Pityriasis versicolor Ring worm or Tinea
More informationSevere β-lactam allergy. Alternative (use for mild-moderate β-lactam allergy) therapy
Recommended Empirical Antibiotic Regimens for MICU Patients Notes: The antibiotic regimens shown are general guidelines and should not replace clinical judgment. Always assess for antibiotic allergies.
More informationnumber Done by Corrected by Doctor د.حامد الزعبي
number Fungi#1 Done by نرجس الس ماك Corrected by مهدي الشعراوي Doctor د.حامد الزعبي Introduction to Mycology -Terms: -Medical Mycology: The study of mycosis and their etiological agents -Mycosis: Disease
More informationFungal infections. Ematologia. Corrado Girmenia. Ematologia, Azienda Policlinico Umberto I Sapienza University of Rome, Italy
Fungal infections Corrado Girmenia Ematologia, Azienda Policlinico Umberto I Sapienza University of Rome, Italy Ematologia Epidemiology Diagnostic approach Prevention strategies Monitoring of IFDs in
More informationMICROBIOLOGICAL TESTING IN PICU
MICROBIOLOGICAL TESTING IN PICU This is a guideline for the taking of microbiological samples in PICU to diagnose or exclude infection. The diagnosis of infection requires: Ruling out non-infectious causes
More informationESCMID Online Lecture Library. by author
How To Best Use Antifungal Agents Cornelia Lass-Flörl Division of Hygiene and Medical Microbiology Innsbruck Medical University ESCMID SUMMER SCHOOL 2012 Epidemiology Diagnosis Roadmap Antifungal drugs
More informationAntifungals in Invasive Fungal Infections: Antifungals in neutropenic patients
BVIKM-SBIMC La Hulpe, 6 November 2008 Antifungals in Invasive Fungal Infections: Antifungals in neutropenic patients Johan Maertens, MD Acute Leukemia and SCT Unit University Hospital Gasthuisberg Catholic
More informationDr Kaniz Fatema. FCPS (Medicine), MD (Critical Care Medicine) Associate Professor Dept of Critical Care Medicine BIRDEM General Hospital
Dr Kaniz Fatema FCPS (Medicine), MD (Critical Care Medicine) Associate Professor Dept of Critical Care Medicine BIRDEM General Hospital 65-years old lady HTN (15 yrs) Adult Still s Disease (2 mon)
More informationnumber Done by Corrected by Doctor
number 19 Done by عمرسامي Corrected by حسام أبو عوض Doctor حامد الزعبي Fungal infections - Fungal infections are infections caused by fungi, a type of microorganisms. Which sites are mostly affected? -
More informationPrimary Antifungal Prophylaxis in Adult Hematopoietic Stem Cell Transplant Recipients: Current Therapeutic Concepts
Primary Antifungal Prophylaxis in Adult Hematopoietic Stem Cell Transplant Recipients: Current Therapeutic Concepts Dorothy McCoy, Pharm.D., Daryl D. DePestel, Pharm.D., and Peggy L. Carver, Pharm.D. In
More information