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BDS3 Microbiology > Candidosis > Flashcards

Candidosis Flashcards

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1
Q

What are the risk factors for developing candidiasis?

A
  • immuno-compromised patients (most of it down to immunosupression)
  • immunosupressive drugs
  • advanced HIV
  • Broad spectrum antibiotics
  • dialysis
  • trauma patient
  • diabetes
  • long term corticosteoid use
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2
Q

What are some infections that can be caused by candidia?

A
  • periodontitis
  • denture implant infection
  • denture stomatitis
  • CF lung infection
  • UTI
  • endocarditis
  • implant/medical device
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3
Q

What are the classifications of oral candidosis?

A
  • pseudomembranous
    • thrush
  • erythematous
    • Atrophic (HIV related)
    • Denture related
  • hyperplastic
    • candidal leukoplakia (can be pre-malignant)
  • Angular chelitis
  • Generalised candidosis with oral manifestations
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4
Q

Describe what pseudomembranous (oral thrush) looks like.

A
  • white plaques that are fairly raised
  • can be wiped off
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5
Q

How does chronic hyperplastic candida leukoplania appear? What do you need to do?

A
  • looks similar to thrush but CANNOT be wiped off
  • the candida is actually in the tissue
  • Need to test for pre-malignancy
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6
Q

What is the main antifungal used for angular chelitits?

A

Topical micanazole

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7
Q

Why are dentures a key surface for candida?

A

-it has lots of little cracks and crevices for the candida to accumulate

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8
Q

What are the 3 grades/types of denture stomatitis? (based on severity)

A
  • Newton’s type I
    • Localised infalmmation
  • Newton’s type II
    • Diffuse inflammation
  • Newton’s type III
    • Granular inflammation
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9
Q

What are the signs and symptoms of denture induced stomatitis?

A
  • Inflamed mucosa (particulary under upper denture
  • Burning sensation
  • Discomfort
  • Bad Taste
  • In most cases patients are unaware of the problem
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10
Q

Describe the process leading to denture stomatitis.

A
  • candida adhere to and colonise on the acrylic surface
  • co-aggregation and biofilm formation
  • toxins are released into the mucosa causing inflammation

The biofilm starts on the denture itself

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11
Q

Candida can be descibed as what ?

A

Opportunistic pathogenic yeasts

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12
Q

What are the 2 main types of candida you will come accross?

A
  • candida albicans
  • Candida glabrate
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13
Q

How is the management of candida albicans and candida glabrata different?

A

Candida albicans is sensitive to fluconazole and miconazole wherease candida glabrata is not and will only grow more if treated with these

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14
Q

Where is candida albicans normally found within the body?

A
  • oral cavity
  • vagina
  • gut (mucosal surfaces)
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15
Q

Candida albicans competes with what and why is this important to know?

A
  • competes with bacteria
  • systemic antibiotics can allow the fungi to outcompete the bacteria and you can end up with thrush
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16
Q

Describe the differences in adhesion between candida albicans and candida glabrata.

A

Candida albicans has hypha that allow it to push through tissues and adhere to them. This is a problems as this is how it can get into the bloodstream

Candida glabrate just adheres to tissues

17
Q

How does candida relate to oral cancer?

A

Chronic candida along with alcohol consumption can drive head and neck cancer

18
Q

What are different ways that you can collect a candidia sample for lab diagnosis?

A
  • oral rinse
  • swab
  • biopsy (possible pre-malignancy)
19
Q

What are the 3 different groups of antifungals?

A
  • echinocandins
  • azoles
  • polyenes
20
Q

What are some examples of echinocandins? How do they work?

A
  • caspofungin
  • Micafungin
  • Anidualafungin

They inhibit glucan synthase whuch destabilises the full cell wall and causes cell death

Note: will be used within the next few years orally for when patients fail to respond to azoles

21
Q

What are some examples of azoles and how do they work?

A
  • fluconazile
  • voriconazole
  • posaconazole

Work on the argosterol

Inhibits the pathway and prevents it being made

Is fungistatic

22
Q

What is an example of a polyene and how does it work?

A

Nystatin

Acts directly on ergosterol and causes pores in the wall

Cytoplasmic contents leak out and causes cell death and lysis

Is fungicidal

23
Q

What is the candida treatment algorithm?

A
24
Q

What are some problems associated with diagnosis and treatment of candida infections?

A
  • people don’t think its a biofilm so follow guildines but forget to disrupt is with good OH
  • Need to think about possible different organisims that might be there because this drives the treatment you give

BDS3 Microbiology (5 decks)

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