Chapter 6 Flashcards
What is the most common fungal infection in humans?
Candidiasis
What fungus causes Candidiasis?
Candida albicans
What are the two forms of candida albicans and which form is infectious?
Yeast form and hyphal form. The hyphal form is infectious.
True or False: Candidiasis is a opportunistic infection
True, but healthy patients may develop infection
What are the clinical patterns of candidiasis?
Psuedomembranous, Erythematous, Chronic hyperplastic and mucocutaneous
What term describes white plaques that resemble cottage, that are removable?
Candidiasis pseudomembranous
What is the common name of psuedomembranous candidiasis in pediatric patients?
Thrush
What things might initiate pseudomembranous candidiasis?
ABX, impairment of the immune system (leukemic patients, HIV, infants), asthma inhalers
Where does pseudomembranous candidiasis usually occur in the mouth?
Buccal mucosa, palate, dorsal tongue
What symptoms can occur with pseudomembranous candidiasis?
Mild burning and a mild unpleasant taste
What are the 5 common presentations of erythematous candidiasis?
Median rhomboid glossitis Chronic multifocal candidiasis Angular cheilitis Denture stomatitis Acute atrophic candidasis
What is another name for median rhomboid glossitis?
Central papillary atrophy
In what population does median rhomboid glossitis occur?
Adults (“disease of adults”)
Describe median rhomboid glossitis
Well demarcated erythematous zone affecting the midline, posterior dorsal tongue (anterior to the circumvallate papilla)
What causes the erythema in median rhomboid glossitis?
Loss of filiform papillae
What is median rhomboid glossitis usually mistkaen as?
Geographic tongue
Describe chronic multifocal candidiasis.
Median rhomboid glossitis + signs of infection at other sites (“kissing lesion”)
Describe angular cheilitis.
Erythema at the folds of the corners of the mouth where saliva can pool
What is the etiology of angular cheilitis?
60% of cases are a combination of Staph aureus and C albicans. The other 40% are either C albicans or S aureus alone
The clinical pattern of angular cheilitis is termed ____________.
Cheilochcandidiasis
Describe denture stomatitis.
Erythema localized to denture bearing areas of a removable denture.
Why does denture stomatitis usually occur?
When the patient continuously wears the denture, it harbors organisms.
What is important to remember when treating denture stomatitis?
Remember to treat both the soft tissues and the denture to prevent recurrence
What is another name for acute atrophic candidiasis?
Antibiotic sore mouth
Describe acute atrophic candidiasis.
Diffuse loss of filiform papillae of dorsal tongue, and the moth feels as though a hot liquid scalded it
What is another name for chronic hyperplastic candidiasis
Candidal leukoplakia
Describe chronic hyperplastic candidiasis
White patch that cannot be removed. This is the least common form of candidiasis
Where does chronic hyperplastic candidiasis usually occur?
Anterior buccal mucosa
Describe mucocutaneous candidiasis.
A rare group of immunologic disorders, where oral lesions are white plaques that do not wipe off.
Young patients with mucocutaneous candidiasis can develop what 3 things?
Endocrine candidiasis syndrome
APECED
Iron deficiency anemia
How is Candidiasis treated?
Antifungal agents (Nystatin, Amphotericin B, Imidazole agents)
What is the most common systemic fungal infection in US?
Histoplasmosis
What fungus causes histoplasmosis?
Histoplasma capsulatum
Which form of histoplasma capsulatum is the infectious form?
The yeast form
Where is Histoplasma capsulatum commonly found?
Humid areas with soil enriched by bird or bat excrement (Ohio and Mississippi River Valley)
How is Histoplasma capsulatum transmitted/where does it germinate?
Airborne spores are inhaled, and germinate in the terminal passages of the lungs. Many of those infected have no/mild symptoms
In what population does Histoplasmosis actually causes symptoms?
Older, debilitated, immunocompromised
Why are oral health care professionals concerned about histoplasmosis?
Oral lesions can occur with disseminated forms of histoplasmosis
What do oral lesions caused by histoplasmosis clinically appear as?
Solitary, painful, long lasting ulceration with firm, rolled margins. (Indistinguishable from malignancy)
What fungus causes blastomycosis?
Blastomyces dermatitidis
Which form (yeast or hyphal) of blastomyces dermatitidis is infectious?
The yeast form
Where is Blastomyces dermatitidis found?
Eastern areas of the US and Canada
Which population is commonly affected by Blastomyces dermatitidis?
Males (more outdoor activity)
True or False: Occurrence of Blastomycosis in immunocompromised patients is rare
True,Occurrence of Blastomycosis in immunocompromised patients is rare
How is Blastomyces dermatitidis transmitted?
Inhalation of spores after a rain, then the spores grow in alveoli of the lungs
What does acute blastomycosis resemble?
Pneumonia
What does chronic blastomycosis resemble?
Tuberculosis
Why are oral health care professionals concerned about blastomycosis?
Oral lesions can results from disseminated infections or local inoculations of Blastomyces dermatitidis
What term describes a benign reaction of the epithelium (looks like cancer) seen in histological slides of blastomycosis?
Pseudoepitheliomatous hyperlasia
What fungus causes paracoccidioidomycosis?
Paracoccidioides brasiliensis
What animal is a reservoir for Paracoccidioides brasiliensis?
Nine banded armadillo
Are males or females more commonly infected by Paracoccidioides brasiliensis?
Males - Protective effect of female hormones, inhibits the transformation of the hyphal form of the organism to the pathogenic yeast form
Under microscopy, Paracoccidioides brasiliensis often appears as a _________ due to _________.
A mariner’s wheel or mickey mouse due to daughter cells budding off the parent cell
What fungus causes coccidioidomycosis?
Coccidioides immitis
What is another name for coccidioidomycosis?
San Joaquin Valley Fever
Where can Coccidioides immitis be found?
Dead or decaying organic matter - It is saprophytic organism
Endemic to the Southwestern US and Mexico
How is Coccidioides immitis transmitted?
Inhalation of spores
What term describes a hypersensitivity reaction to Coccidioides immitis characterized by multiple painful inflammatory nodules on the legs?
Erythema nodosum
What is Valley fever?
Erythema nodosum occurring in conjuction with coccidioidomycosis
What fungus causes Cryptococcosis?
Cryptococcus neoformans
Where can Cryptococcus neoformans be found?
Pigeon excrement
What is a unique feature of Cryptococcus neoformans?
Cryptococcus neoformans has a prominent mucopolysaccharide capsule that protects it from host defense
What population is commonly affected by cryptococcosis?
Immunocompromised patients
What is the most frequent site of involvement in disseminated infections of cyrptococcosis?
Meninges
What is another name for Zygomycosis?
Mucormycosis
Where are zygomycota found?
Found of decaying organic material
What is the most important concern about zygomycosis?
The Rhinocerebral form, because you can’t do surgical debridement of the brain
What enhances the growth of zygomycota?
Iron
What patients are at risk for zygomycosis and why?
Uncontrolled diabetics because ketoacidosis inhibits iron binding to transferrin, which allows iron levels to rise
Patients taking deferoxamine
Immunocompromised patietns
Zygomycota are attracted to blood vessels and can cause occlusion of the vessels, resulting in tissue that appears ______ and ______
Appears black and necrotic
What are the 2 forms of aspergillosis?
Noninvasive and invasive
What does noninvasive aspergillosis causes?
Affects a normal host, and is an allergic reaction affecting the sinuses (allergic fungal sinusitis)
What term describes a large mass of fungal hyphae is aspergillosis?
Aspergilloma
What population is affected by invasive aspergillosis?
Immunocompromised patients
True or False: Aspergillosis is rare
Falso, Aspergillosis is the 2nd most common fungal infection
What are the two common species of fungus that causes aspergillosis?
A fumigatus, and A flavus
Which fungus can be found in bird or bat excrement?
Histoplasma capsulatum
Which fungi are saprophytic organisms (lives on decaying organic matter?
Coccidioidmycosis, Zygomycosis
