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Flashcards in Immunosuppression and infections Deck (11)
1

Cryptococcus post liver transplant-

amphotericin B
and do an LP

2

CMV post liver transplant-

ganciclovir

3

Candidal infection post liver transplant-

As a general rule, if candidal species grow from 2 or more sites, even if not from blood (eg, urine, wound), the condition should be managed as a systemic infection.

Traditional treatment for systemic candidiasis has been intravenous amphotericin B. Amphotericin must be administered intravenously and has synergistic renal toxicity with cyclosporine.

Ketoconazole is avoided because it can cause a dramatic increase in cyclosporine levels and may be hepatotoxic.

4

Aspergillos isinfection post liver transplant-

Voriconazole
or
Amphotericin B

5

Legionella and pneumocystis infection post liver transplant:

o pulmonary infiltrate of unknown etiology erythromycin (1 g IV q6h) for Legionella infections + trimethoprim-sulfamethoxazole for PCP
o commonly manifest as dyspnoea and hypoxemia before the chest radiographs show a significant infiltrate.

6

Strongyloides stercoralis: what is the source?

Moist faecally contaminated soil with INTACT ckin

7

What does strongyloides look like clinically?

Diarrhoea, abdominal pain, rash urticarial

Hyperinfection in immunocompromised

8

How do you treat strongyloides?

Ivermectin or albendazole

9

Thalassaemia predisposes to what infection?

Yersinia enterocolitica

Looks like acute abdomen
Happens in other iron overloaded people, people getting chelated

10

Candida sepsis?

anidulafungin or caspofungin

If stable, non neutropaenic, no azole exposure- can give fluconazole

11

EBV acute infection serology

VCA IgM positive (1-3 months)
VCA IgG positive (stays for life)
EBNA IgG not positive until at least a month so excludes acute infection. Stays positive for life