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Oral Pathology > Fungal Infections > Flashcards

Fungal Infections Flashcards

1
Q

organism causing histoplasmosis

A

histoplasma capsulatum

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2
Q

geographic predilection of histoplasmosis

A

endemic to ohio and mississippi river valleys

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3
Q

transmission of histoplasmosis

A

spores in bird or bat droppings

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4
Q

histoplasmosis mimics what disease

A

TB

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5
Q

clinical features of acute histoplasmosis

A

flu-like illness

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6
Q

clinical features of chronic histoplasmosis

A

cavitary pulmonary lesions

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7
Q

disseminated histoplasmosis effects what population

A

elderly, debilitated, or immunocompromised

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8
Q

oral clinical features of histoplasmosis

A

localized disease secondary to implantation over previously traumatized mucosa

associated with disseminated disease

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9
Q

clinically, histoplasmosis may be identical to

A

malignancy

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10
Q

special stains to detect fungal organisms in tissue

A

silver stain (GMS) or PAS

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11
Q

treatment of chronic or disseminated histoplasmosis

A

amphotericin B

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12
Q

treatment of mild or maintenance therapy of histoplasmosis

A

ketoconazole or itraconazole

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13
Q

cause of blastomycosis

A

blastomyces dermatitis

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14
Q

geographic predilection of blastomycosis

A

extends into Wisconsin, Minnesota, and Canada

sporadic cases in other parts of world

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15
Q

when disseminated, affected sites of blastomycosis include

A

skin
bone
prostate
meninges
oropharyngeal mucosa
visceral organs

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16
Q

acute blastomycosis

A

pneumonia like symptoms

high fever, chest pain, productive cough, night sweats

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17
Q

chronic blastomycosis

A

TB like symptoms

night sweats, low grade fever, wieght loss, cough, hilar, masses on x-ray

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18
Q

skin and oral mucosa lesions of blastomycosis

A
  1. enlarging erythematous nodules that ulcerate
  2. varying degrees of pain
  3. oral lesions resemble squamous carcinoma
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19
Q

identification of yeasts of blastomyces dermatitidis

A

identification of characteristic yeasts (8-20. microns) in histologic sections stained with methenamine silver or PAS technique

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20
Q

treatment of blastomycosis

A

systemic amphotericin B

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21
Q

etiology of coccidioidomcyosis

A

coccidioides immitis

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22
Q

geographic localization of coccidioidomycosis

A

endemic to desert southwest US

valley fever

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23
Q

clinical features of coccidioidomycosis

A
  1. inhalation of spores
  2. flu-like illness in 40% of infected patients
  3. dissemination in <1%
  4. skin of central face may be affected; oral lesions are rarely described
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24
Q

histopathology of coccidiodomycosis

A
  1. large (20-60micron) spherules that contain endospores
  2. variable host response, ranging from acute to granulomatous inflammation
  3. diagnosis can be made by culture or biopsy
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25
Q

treatment of coccidioidomycosis

A

amphotericin B for disseminated cases

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26
Q

cause of cryptococcosis

A

cryptococcus neoformans

27
Q

how humans contract cryptococcosis

A

organisms live in pigeon droppings

transmitted by air borne spores

28
Q

predisposing illnesses for crytococcosis

A

affects immunosuppressed patients exclusively

29
Q

presenting features of cryptococcosis

A
  1. flu like symptoms with initial pulmonary infection
  2. disseminates to meninges
  3. cutaneous lesions may develop in 10-20%
  4. oral lesions are rare
30
Q

histopathology of cryptococcosis

A

4-6 micron yeasts with clear halo

31
Q

treatment of cryptococcosis

A

severe cases treated with amphotericin B and flucytosine

fluconazole for less severe cases

32
Q

prognosis for cryptococcosis

A

poor because most patients are immunocompromised

33
Q

cuase of aspergillosis

A

severeal species of aspergillus genus

34
Q

different types of infections from aspergillosis

A

allergy
localized infection
invasive aspergillosis

35
Q

spores of fungus aspergillosis commonly found in

A

spores in soil, water, decaying organic debris

36
Q

clinical features of infection with aspergillosis

A

-allergy may trigger asthma
-tissue damage post extraction
-aspergilloma

37
Q

histology of aspergillus flavus

A

branching septate hyphae

occlusion of small vessels by hypahae

38
Q

vasoinvastion and vaso-occlusion is seen in what two diseases

A

aspergillus and zygomycetes

39
Q

treatment of aspergillosis

A

amphotericin B (with or without debridgement)

40
Q

prognosis of aspergillosis

A

good prognosis if normal immune status

poor prognosis if immunocompromised

41
Q

zygomycosis and diabetes

A

affects severe diabetic or immunocompromised patients

42
Q

features of rhino cerebral form of zygomycosis

A
  1. form in oral region
  2. nassal obstruction + blood nasal discharge
  3. black necrotic lesions
  4. progression superiorly, visual disturbances and blindness
  5. seizures and death
43
Q

histopathological appearance of zygomycosis

A

large branching nonseptate hyphae with extensive tissue necrosis

44
Q

treatment of zygomycosis

A

radical surgical debridement

IV amphotericin B

45
Q

prognosis of zygomycosis

A

poor (death within hours - days)

46
Q

yeast / spore form of candida

A

commensal

47
Q

hyphal form of candida

A

pathogen

disease causing form

48
Q

germ tube

A

ability of yeasts to undergo transofmraiton to hyphal form under appropriate conditions, producing germinative or germ tubes

49
Q

mycelia

A

colony of hyphae with / without spores

50
Q

predisposing factors of candida

A

host immune status
oral mucosal environment
virulence of candida strain

51
Q

white candida lesions

A

acute pseudomembranous candidiasis

hyperplastic candidiasis

52
Q

red candida lesions

A

acute atrophic candidiasis

central papillary atrophy of tongue

chronic atrophic candidiasis

53
Q

other forms of candida

A

angular cheilitis

54
Q

acute pseudomembraneous candidiasis

A

-thrush
-white curdled milk or cottage cheese like
-pseudomembranous (CAN BE WIPED OFF)
-asymptomatic

55
Q

hyperplastic candidiasis

A

-candidal leukoplakia
-white patch that cannot be rubbed off
-anterior buccal mucosa
-should resolve with antifungal therapy
-SHOULD BIOPSY

56
Q

acute atrophic candidiasis

A

-redness
-tongue common site
-diffuse atrophy of dorsal tongue papillae, particularly after broad spectrum antibiotics

57
Q

central papillary atorphy of tongue

A

referred to as median rhomboid glossitis

-most due to chronic candidiasis
-well defined area of redness

58
Q

chronic atrophic candidiasis

A

-denture sore mouth
-denture is contaminated with candida organism, no invasion of mucosa is seen
-erythema of palatla denture bearing area

59
Q

angular chelitis

A

candidiasis, but ay have cutaneous bacteria mixed

-redness at corners of mouth

60
Q

diganosis of candidiasis

A

clinical signs and symptoms are sufficient

61
Q

preferred treatment of oral candidiasis

A

nystatin (mycostatin)

62
Q

nystatin (mycostatin)

A

not absorbed systemically, msut be in contact with organism to be effective

63
Q

clotrimazole (mycelex)

A

pleasant tasting lozenges

must be taken 5x per day

Oral Pathology (14 decks)

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