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Oral Pathology, Stephen > chpt 6 Fungal infections > Flashcards

chpt 6 Fungal infections Flashcards

1
Q

Infection from a yeastlike fungal organism

A

Candidiasis (older pts call it moniliasis)

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2
Q

what is dimorphism and why important to Candidiasis

A

can exist as yeast (innocuous) or hypae (infectious)

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3
Q

Most Common oral fungal infection in humans

A

candidiasis

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4
Q

Best recognized form of oral candidiasis

A

pseudomembranous candidiasis (Thrush)

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5
Q

2 common ways to get the opportunistic fungal infection Candidiasis

A

antibiotic treatment Steroid inhalers

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6
Q

Clinical appearance of Pseudomembranous Candidiasis

A

cottage cheese like white plaques that scrape off commonly occurring on cheeks, palate, dorsal tongue

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7
Q

2 ways to get pseudomembranous oral candidiasis

A

broad spectrum antibiotics Immune suppression

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8
Q

Symptoms of pseudomembranous oral candidiasis

A

burning sensation

Alternating unpleasant salty/bitter taste

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9
Q

What candidiasis form is more common than pseudomemberanous oral candidiasis

A

Erythmatous candidiasis

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10
Q

When does Erythmatous Candidiasis present and with what symptoms

A

after broad spectrum antibiotic Antibiotic sore mouth

Scalded mouth

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11
Q

What is the clinical appearance of Erythmatous Candidiasis

A

diffuse loss filiform papillae dorsal tongue w/ red/bald tongue appearance

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12
Q

What is a risk factor for Erythmatous Candidiasis

A

Xerostomia (pharmacologic, Sjogren’s)

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13
Q

What is median rhomboid glossitis

A

Central papillary atrophy of tongue, a form of erythmatous candidiasis. Midline, posterior dorsal tongue

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14
Q

External appearance of chronic multifocal candidiasis

A

angles of the mouth (Angular Cheilitis)

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15
Q

How tell difference between Leukoplakia and Chronic Hyperplastic Candidiasis (both are white lesions that will not rub off)

A

histology of chronic hyperplastic candidiasis will have fungal hyphae

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16
Q

2 ways to prevent Candidiasis

A

take probiotics or increase active yogurt culture intake while taking antibiotics

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17
Q

Siversky’s preferred antifungal treatment for Candidiasis infection

A

Clotrimazole 10mg

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18
Q

Causes of Angular Cheilitis

A

1) Loss Vertical Dimension
2) Vitamin B Deficiency
3) Immunosuppressed w/ Candidiasis

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19
Q

Exfoliative lesions of the vermillion zone and perioral skin due to superficial candidal infection

A

Cheilocandidiasis(Angular cheilitis)

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20
Q

Angular cheilitis can be a mixture of what

A

20% candidiasis alone
60% Candidiasis + S. Aureus
20% S. Aureus alone

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21
Q

Siversky’s Angular cheilitis Treatment

A

Mycolog II (Nystatin antifungal 100,000 units/gram and Triamcinolone low dose steroid .1%)

22
Q

Why pair a low dose steroid (Triamcinolone) with anti-fungal (Nystatin)

A

steroid decreases inflammation caused by antifungal

23
Q

What is Siversky’s treatment for Central Papillary Atrophy/Median Rhomboid Glossitis

A

tongue scraper

24
Q

Form of Erythmatous candidiasis that is due to 24 hour denture wear, and is confined to the denture bearing areas of the mouth

A

Denture stomatitis

25
Q

Treatment for Denture Stomatitis (form of Erythmatous Candidiasis)

A

treat candidiasis Remake denture

OHI (remove/soak/brush denture, brush palate)

26
Q

What must be present in histology for a Candidiasis diagnosis

A

Hyphae or pseudohyphae (elongated yeast cells)

27
Q

What can Candidiasis be superimposed on

A

1) Lichen planus
2) Leukoplakia
3) Squamous Cell carcinoma

28
Q

Systemic antifungal Siversky would use to treat Candidiasis

A

Fluconazole

29
Q

Most common systemic fungal infection in US, especially HIV

A

Histoplasmosis (generally a pulmonary disease)

30
Q

Histoplasmosis found commonly in what areas

A

humid areas w/ soil enriched by bird or bat excrement

31
Q

Of the three forms of Histoplasmosis (Acute, Chronic, Disseminated), which manifests oral lesions

A

Disseminated

32
Q

Most commonly affected sites by Disseminated Histoplasmosis

A

tongue, palate, buccal mucosa

33
Q

What is the clinic presentation of Histoplasmosis

A

solitary, variably painful ulcer of several week’s duration possibly with rolled margins making it look malignant

34
Q

Histoplasmosis histology that is like Tuberculosis and Sarcodosis

A

Granulomas

35
Q

Treatment for Acute Histoplasmosis

A

None. Self-limiting

36
Q

Treatment for Chronic Histoplasmosis

A

IV Amphotericin B if does not resolve (significant kidney damage from Amphotericin B)

37
Q

What can be used to treat Chronic Histoplasmosis if patient is nonimmunosuppressed

A

3 months Itraconazole

38
Q

Opportunistic fungal infection normally from decaying material

A

Zygomycosis

39
Q

Who is Zygomycosis found commonly in

A

uncontrolled diabetics w/ ketoacidosis

40
Q

Why is ketoacidosis helpful to Zygomycosis infection

A

ketoacidosis inhibits iron binding which increases serum iron. Iron enhances zygomycosis fungal growth

41
Q

Rhinocerberal Zygomycosis has what clinical symptoms

A
  • Nasal obstruction
  • Bloody noses
  • Facial pain/swelling/cellulosis
  • Facial paralysis
  • Blindness (advanced stages)
  • Seizures (advanced stages)
42
Q

Histology of Zygomycosis

A

90 deg branching thick hyphae w/ extensive necrosis

43
Q

Treatment for Zygomycosis

A

surgical debridement

High dose amphotericin B

44
Q

Fungal infection with both invasive and non-invasive forms from soil, water, or decay

A

Aspergillosis

45
Q

Only what form of Aspergillosis grows at 37 C.

A

Pathogenic

46
Q

Clinical presentation of Aspergillosis

A

Show as allergic fungal sinusitis

47
Q

What is the mass of fungal hypae called when the infect the maxillary sinus

A

Aspergilloma

48
Q

What is the differential for a mass found in the maxillary sinus (Antrolith)

A

Sinusitis

Aspergillosis

49
Q

Can there be necrosis with Aspergillosis

A

Yes, the hyphae can occlude blood vessels

50
Q

Aspergillosis immunocompetent treatment

A

Local debridement, corticosteroid, antifungal

Oral Pathology, Stephen (13 decks)

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