Fungal Infection Flashcards
What % population harbour Candida
40-70%
What is Candida-pseudomembraneous
Creamy non adherent white plaque like lesions
Soft palate with steroid inhaler
What investigations for Candida
Swab
Identify systemic risk factors
Investigate for anaemia, diabetes, immunosuppression
Management for Candida
Antifungal - fluconazole 50mg daily 7 days
HIV screen? (NICE guidelines)
How does acute erythematous candidosis usually present from pt description
Antibiotics
Sore mouth
Diagnosis of AEC
Erythematous area
Painful
Typically dorsum of tongue
Investigations for AEC
Swab
Correct systemic risk factors
Investigate anaemia, diabetes, immunosuppression
Management got AEC
Address cause
Systemic antifungal - fluconazole 50mg daily
Diagnosis for chronic hyperplasticity candidosis
White adherent plaques (nodular/speckled)
Homogenous or heterogenous
Bilateral commissure region
Dorsum of tongue
Investigations of CHC
Incisional biopsy for dysplasia
(Invasion of epithelium by Candida hyphae)
Management for CHC
Systemic fluconazole (50mg daily)
Smoking cessation
Risk factors for CHC
Smoker
COPD (steroid inhalers)
Dentures
Diabetes
What is chronic erythematous candidosis also known as
Denture stomatitis
How many denture wearers get denture stomatitis
65%
Clinical diagnosis for CEC
Most frequent candidosis presentation
Erythematous area one denture bearing surface
Usually non painful unless severe
Management of CEC
Topical antifungal
Miconazole gel
Denture hygiene instruction
Angular cheilitis clinical diagnosis
Erythematous area at angle of mouth - bilateral
Painful and sore
May accompany intra oral candidosis
Investigations for angular cheilitis
Swabs
Combination with staph or MRSA
Management for angular cheilitis
Treat underlying cause (decreased vertical dimension, drooling)
Topical antimicrobial (miconazole)
Clinical diagnosis for median rhomboid glossitis
Red depopulated area in dorsum of tongue
Painless
Corresponding kissing lesion
Steroid use, dentures, immunodeficiency, smokers
What is median rhomboid glossitis a form of
Chronic erythematous candidosis
Investigations for median rhomboid glossitis
Rule out underlying cause
Swabs
Management for MRG
Antifungals
Treat underlying cause
What factors predispose to oral candidosis
Physiological - age and pregnancy
Local trauma - denture
Antibiotics - broad spectrum
Corticosteroids - inhaler/ systemic
Endocrine - diabetes
Malignancy - SCC, leukaemia
Immune deficiency - HIV
Xerostomia - drug related, sjogrens
High carb diet
Anaemia
Management for Candida
Correct local factors
Correct systemic factors
Antimicrobial - topical and systemic
Follow up
What are topical antifungals
Nystatin QDS 1/52
Miconazole gel 2.5ml QDS
What are systemic antifungals
Fluconazole caps 50mg 2/52 od
What are antifungal MOA
Polyenes (nystatin)
Disrupt cell membrane
Fungicidal
Azoles
Inhibit eegosteril synthesis
Fungistatic
Interact with warfarin
