252.2 📚 國考版

252.2.0.1 必背 — Candida auris

• WHO critical priority pathogen
• 2009 Japan emergence
• Multi-drug resistant (high fluconazole-R; some echinocandin-R)
• Hospital outbreaks — environmental persistence
• Echinocandin first-line + AmB combination for severe
• Contact precautions + cohorting + environmental cleaning
• Difficult to identify (MALDI-TOF + PCR)

252.2.0.2 必背 — Fusarium

• Neutropenic + leukemia + HSCT
• Disseminated with skin lesions (multiple painful nodules)
• Blood cultures often positive (unique among molds)
• Voriconazole + liposomal AmB combination
• Mortality 50-80%

252.2.0.3 必背 — Lomentospora prolificans

• Multi-drug resistant mold
• Drowning, immunocompromise, CF
• Voriconazole partial activity; olorofim Phase 3 promising

252.2.0.4 必背 — Trichosporon

• Neutropenic disseminated yeast
• Cross-reacts with cryptococcal antigen test
• Voriconazole preferred (echinocandins NOT active)

252.2.0.5 必背 — Dematiaceous (Black) Fungi

• Pigmented hyphae; tropical + immunocompromise
• Cutaneous + sinus + CNS abscess
• Fontana-Masson stain
• Itraconazole / voriconazole + surgery

252.2.0.6 必背 — Newer Antifungals (Emerging Fungi)

• Ibrexafungerp (FDA 2021)
• Fosmanogepix (Phase 3)
• Olorofim (Phase 3)

252.2.0.7 必背 — Echinocandins NOT Active

• Cryptococcus
• Mucor / Rhizopus
• Trichosporon
• Lomentospora prolificans
• Some Candida auris (variable)
• Fusarium (variable)

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