Infeksi jamur pada paru 2

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  • Macrophages: immune system cells that attack foreign organismscarry the spores to lymph nodes in chest continue to multiply may lead to inflammation, scarring and calcium deposits heavy infection: lymph nodes may become so enlarged that they obstruct esophagus/lungs' airways
  • may resemble Tuberculosis
  • Anemia: decrease in red blood cells or less quantity of hemoglobin in blood
  • Fungal Culture: several weeks to confirm diagnosis, test isn't used when immediate treatment is neededBlood Test: AntibodiesChest X-ray: single pulmonary nodule of histoplasmosisTransbronchial biopsy: bronchoscope is inserted through the nose or mouth to collect several pieces of lung tissue
  • Amphotericin B to briefly start if serious, then followed by an oral antifungal
  • Infeksi jamur pada paru 2

    1. 1. Infeksi Jamur pada Paru 1
    2. 2. Histoplasmosis: Ohio Valley Fever• Histoplasma capsulatum – most common true pathogen; causes histoplasmosis• Distributed worldwide, most prevalent in eastern and central regions of US• Grows in moist soil high in nitrogen content• Inhaled conidia produce primary pulmonary infection that may progress to systemic involvement of a variety of organs and chronic lung disease.• Amphotericin B, ketoconazole 2
    3. 3. PORTAL OF ENTRY INHALATION INOCULATION (rare)
    4. 4. 4
    5. 5. Cause• Spores – trapped by macrophages – germinate in lungs• Infection spreads through body in blood stream
    6. 6. Acute Symptoms Asymptomatic: in › No symptoms › Most common Symptomatic: › Fever › Chills/Sweats › Muscle Aches › Cough › Loss of appetite › Chest pain breathing
    7. 7. Chronic Symptoms 5% of those who are infected › Chronic histoplasmosis Chest pain  Fever Shortness of breath  Excessive sweating Cough › May bring up blood Weight loss
    8. 8. Disseminated SymptomsFevers AnemiaHeadache Weight loss:Pneumonia › DiarrheaNeck stiffness › Loss of appetite › Swollen lymph nodes Infection of heartSkin lesions valves › Mouth and nose sores
    9. 9. Other Symptoms• Enlarged – Liver – Spleen – Adrenal gland• Joint pain• Rashes• Skin nodules – tender red lumps • erythema nodosum
    10. 10. Diagnosis• Fungal culture• Fungal stain• Blood test• Chest X-ray – distinct markings on lungs• CT scan• Transbronchial biopsy
    11. 11. CLINICAL SPECIMENS• SPUTUM• BONE MARROW• BIOPSY MATERIAL• BRONCHIAL WASHINGS• PERIPHERAL BLOOD• GASTRIC WASHINGS
    12. 12. Identification• 1. Microscopic observation• 2. Conversion• 3. DNA Probe
    13. 13. SEROLGICAL TEST• COMPLEMENT FIXATION – MYCELIAL FORM ANTIGEN – YEAST FORM ANTIGEN• IMMUNODIFFUSION – H = ACUTE INFECTION – M = PAST, PRESENT OR SKIN TEST
    14. 14. SEROLGICAL TESTS• EIA detects antibody• EIA to detect ANTIGEN (systemic disease)
    15. 15. ECOLOGICAL ASSOCIATION• Blackbird roosts• Bats• Bat guano• Chicken houses
    16. 16. Treatment Antifungal drugs › IV  Amphotericin B (Fungizone IV, Abelcet) › Oral  Itraconazole (Sporanox)  Ketoconazole
    17. 17. Prevention• Minimize exposure to dust in contaminated environments – Chicken coops – Bat caves• Wear breathing apparatus – Masks• Spray contaminated soil

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