06 Fungal infections Flashcards

1
Q
A

candidiasis

  • dimorphic (yeast, hyphal)
  • opportunistic
  • pseudomembranous, erythematous, hyperplastic, angular cheilitis, denture stomatitis, median rhomboid glossitis
  • treat with clotrimazole
  • use probiotics when taking antibiotics
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2
Q
A

pseudomembranous candidiasis

  • white plaques like cottage cheese
  • tangled mass of hyphae, yeasts, debris
  • scrapping to remove
  • mild symptoms, burning sensation, unpleasant taste
  • typically on buccal muccosa, palate, dorsal tongue
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3
Q
A

erythematous candidiasis

  • most common, but overlooked
  • missing white component
  • ‘antibiotic sore mouth’ following broad spectrum treatment
  • loss of filliform papillae leads to red bald tongue
  • higher incidence in xerostomic patients
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4
Q
A

hyperplastic candidiasis

  • not removed by scrapping
  • least common
  • possibly candidiasis over preexisting leukoplakia
  • intermingled red/white areas
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5
Q
A

angular cheilitis

  • loss of vertical deminsion
  • Vit. B deficient
  • cheilocandidiasis - candidal infection at vermillion borders
  • 20% candida, 60% candida + staph aureus, 20% staph aureus
  • treat w/ mycolog II ointment, Vit. B complex
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6
Q
A

central papillary atrophy

median rhomboid glossitis

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7
Q
A

denture stomatitis

  • form of erythematous candidiasis
  • AKA chronic atrophic candidiasis
  • poor denture hygiene
  • treat candidiasis, remake denture, improve hygiene
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8
Q

mucocutaneous candidiasis

A
  • suspect when infections of mouth, nails, skin and other mucosal surfaces
  • component of rare group of immunologic disorders
  • mutations of autoimmune regulator gene
  • increased oral/esophageal cancer
  • control candida with antifungals
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9
Q

candida histopathologic features

A
  • PAS stain - bright magenta
  • hyphae or pseudohyphae must be present to diagnose
  • may be superimposed on LP, leukoplakia and squamous cell carcinoma
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10
Q

candida treatments

A
  • nystatin - bitter taste, sucrose, poorly absorbed
  • clotrimazole - poorly absorbed, antibacterial/antifungal, elevates liver enzymes
  • ketaconazole - need acid environment for absorption, liver issues
  • fluconazole - more effective than ketacon., acid not needed, side effects with phenytoin/anticoagulants/hypoglycemic agents
  • iodoquniol- antibacterial/antifungal, cream base effective for angular cheilitis
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11
Q

histoplasmosis

A

most common systemic fungal infection in US

  • humid areas
  • bird or bat excrement
  • spores inhaled, multiply in lymph nodes and spread systemically
  • oral lesions on tongue, palate, buccal mucosa
  • painful and mimic malignancy
  • multinucleated giant cells with granulomatous inflammation
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12
Q

histoplasmosis treatment

A
  • acute cases self limiting requiring no treatment
  • half chronic cases recover spontaneously
  • amphotericin B in severe cases, kidney damage
  • itraconazole for 3 months in nonimmunosuppressed
  • disseminated form 80-90% death rate
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13
Q

zygomycosis

A
  • opportunistic
  • ketoacidotic diabetics
  • serum iron levels rise because ketoacidosis inhibits iron binding in transferrin
  • fungal growth increased by iron
  • AKA mucormycosis and phycomycosis
  • spores found on decaying material
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14
Q

zygomycosis symptoms and treatment

A
  • nasal obstruction, bloody nasal discharge, facial swelling, cellulitis, visual disturbances
  • facial paralysis with cranial nerve involvement
  • blindness, lethargy, seizures, death in progressive cases
  • histological necrosis with hyphae brancing at 90degrees
  • surgical debridement
  • high dose amphotericin B
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15
Q

aspergillosis

A
  • invasive or non-invasive forms
  • invasive more in immunocompromised
  • found in saprobic organisms, water and decaying debris
  • spores released in air
  • most aspergillus species can’t grow at 37degrees C, only pathologenic species
  • allergic fungal sinusitis - infection of maxillary sinus forms mass fungal hyphae and may undergo dystrophic calcification (antrolith)
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16
Q

most common granulomatas diseases

A
  • TB - caseating necrosis
  • sarcoidosis
  • Crohn’s disease