Fungal and Protozoal Disease Flashcards
What is the most common oral fungal infection in humans?
Candidiasis
*caused by candida albicans
What are the two forms (dimorphism) or Candida?
1-Yeast form- innocuous
2-Hyphal form-invasion of host tissue
What are the 4 main categories for Candidal manifestation?
1-Pseudomembranous
2-Erythematous (5 subcategories)
3-Chronic hyperplastic (does not rub off)
4-Mucocutaneous
Which form of candidiasis is adherent white plaques that wipe off and typically called thrush?
Pseudomembranous Candidiasis
*Mild burning, Initiated by antibiotics, impaired immune system and inhalers
Which form of candidiasis is often overlooked clinically, is more common that pseudomembranous and does not have major white lesions?
Erythematous Candidiasis
*5 subtypes
What are the 5 clinical presentations of Erythematous candidiasis?
1-Median rhomboid glossitis 2-Chronic multifocal candidiasis 3-Angular cheilitis 4-Denture stomatitis 5-Acute atrophic candidiasis
AKA Central papillary atrophy what presents as a well-demarcated erythematous zone affecting the midline, posterior dorsal tongue?
Median Rhomboid glossitis
*erythema due to loss of filiform papillae
Median rhomboid glossitis plus signs of infection at other sites such as the hard or soft palate or angles of the mouth is called?
Chronic multifocal candidiasis
What forms as a sore in the corners of the mouth where saliva can pool?
Angular cheilitis
What are the 3 main causes of Angular cheilitis?
1-C albicans only 20%
2-Staph Aureus only 20%
3-Combo of both 60%
Usually due to chronic lip licking, what is it called what angular cheilitis includes the whole lip?
Cheilocandidiasis
AKA Chronic atrophic candidiasis, what condition is localized erythema due to denture-bearing areas of a maxillary removable denture?
Denture Stomatitis
*Remember to treat both denture and tissues
What condition is called • “Antibiotic sore mouth” because it usually follows a course of broad-spectrum ABX and appears as a bald tongue?
Acute atrophic candidiasis
*loss of filiform papillae. mouth feels as though hot liquid scalded it
AKA Candidal leukoplakia, what condition appears as white patches that cannot be removed and is the least common form of candidiasis?
Chronic hyperplastic candidiasis
*usually anterior buccal mucosa
Which condition is a rare group of immunologic disorders and presents with oral white plaques that do not rub off?
Mucocutaneous Candidiasis
What are the three types of mucocutaneous candidiasis that can be developed?
1-Endocrine-candidiasis syndrome
2-Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) syndrome
3-Iron-deficiency anemia
What are three main treatments for Candidiasis?
1-Nystatin (antifungal)
2-Amphotericin B
3-Imidazole such as Clotrimazole
Which candidiasis treatment should you not use in xerostomia-related cases due to added sugar?
Nystatin
*is bitter and comes as rinse or lozenge
Which Candidiasis treatment is for life-threatening systemic fungal infection and is IV?
Amphotericin B
Which candidiasis treatment has very few side effects, and is formulated as a troche (lozenge)?
Imidazole agents
What is the most common systemic fungal infection in the US?
Histoplasmosis
*Caused by Histoplasma capsulatum. Mild flu-like symptoms usually
What are the two forms of Histoplasma capsulatum?
1-Yeast at body temperature in human host
2-Mold in natural environment
Histoplasma capsulatum is found in bird or bat excrement in what areas?
Ohio and Mississippi River Valley
What uncommon disease is due to inhalation of spores after a rain and resembles pneumonia in its acute form and tuberculosis in its chronic form?
Blastomycosis
*Caused by Blastomyces dermatitidis. 9:1 male:female ratio
What are the two forms of Blastomyces dermatitidis?
1-Grows as yeasts at body temperature
2-Grows as mold in rich, moist soil
What is the histological term for the benign reaction of epithelium that blastomyces dermatitidis can cause?
pseudoepitheliomatous (pseudocarcinomatous) hyperplasia
*Can look like cancer
Which disease is carried by the nine-banded armadillo, and resembles mickey mouse or a mariners wheel?
Paracoccidioidomycosis (South American Blastomycosis)
*Caused by Paracoccidioides brasiliensis. Associated with agriculture
AKA San Joaquin valley fever, which disease is caused by inhaled spores southwestern US and Mexico?
Coccidioidomycosis
*Caused by Coccidioides immitis
Affecting the legs, what is it called when a patient has a hypersensitivity reaction in conjunction with Coccidiodes immitis infection?
Erythema nodosum
Which disease lives in pigeon excrement, has a mucopolysaccharide capsule and most often involves the meninges when dissemeninated?
Cryptococcosis
*Caused by Cryptococcus neoformans (yeast form in tissue and host)
AKA mucormycosis, which disease can be found on decaying organic material, is enhanced by iron and may result in rhinocerebral zygomycosis?
Zygomycosis
*Radical debridement often necessary with high dose amphotericin B
What 3 groups of patients are at risk for zygomycosis?
1-Diabetic patients who are uncontrolled (Ketoacidosis inhibits iron binding to transferrin, allowing serum iron levels to rise)
2-Patients taking deferoxamine (iron-chelating agent)
3-Immunocompromised patients
Which disease has an invasive as well as non-invasive infective state and is the second most frequent infection?
Aspergillosis
*Surgical debridement
What are the two most common species that cause aspergillosis?
1-A. fumigatus (90%)
2-A. flavus
Which type of aspergillosis is an allergic reaction affecting the sinuses and may cause a large mass of fungal hyphae called aspergilloma?
Noninvasive infection
*Calcified aspergilloma is called antrolith
Which type of aspergillosis is localized in normal host but extensive in immunocompromised patients?
Invasive infection
