fungal infections Flashcards
what is the causative organism for most dermatophyte infections
trichophyton rabrum
what causees 20% of dermatophyte infections
trichophyton mentagraphytes
what is a rare cause of dermatophyte infections
microsporum canid
tinea capitis
infection in the scalp
tinea barabae
infection in the beard
tinea corpis
infection in the body
tinea mannum
infection in the hand
tinea unginuium
infection of the nail
tinea cruris
infection in the groin
tinea pedis
infection in the foot
presentation of dermatophyte infection
erythematous rash, scaly, itchy, ring shaped lesion with an actively expanding edge and resolving centre - wet maceration in flexural areas
diagnosis of dermatophyte infections
skin scraping from edge of lesion or nail clipping
management of localised dermatophyte infections
topical anti fungals - clotrimazole, miconazole
treatment of athletes foot
terpinafine BD - 7 days
management of widespread or nail dermatophyte infecions
oral anti fungals - terbinafine,
what is candida albicans
a yeast infection
who is candida albicans common in
immuno suppressed patients
locations where candida albicans is usually found
under breasts, fat rolls, nappy area
presentation of candida albicans
mouth - white lesions that can be scraped off
genital - white discharge itch
skin - itchy scale erythema with ragged peeling edges and satellite lesions
diagnosis of candida albicans
skin scraping
treatment of candida albicans in the mouth
nystatin
treatment of candida albicans in the genital region
topical clotrimazole
treatment of candida albicans in the skin
topical clotrimazole or oral antifungal
what does the use of oral antifungals such as terinafine require
LFT monitoring due to hepatoxicity
what is pityriasis versicolor
a yeast infections caused by melassezia
where does pityriasis versicolor usually appear
in hot humid conditions
presentation of pityriasis versicolor
well defined macular lesions with fine scale that are either hypo or hyper pigmentated on the back chest and arms
when is pityriasos versicolor usually picked up
on holiday
what is the management of pity versicolor
topical anti fungals - selenium sulphide, ketocolazole
what is impetigo
a highly contagious superficial skin infection that typically affects children
causative organism of impetigo
staph A or strep pyogenes
what is the presentation of impetigo
face - well defined lesions with a honey coloured golden crust and erythematous base
management of impetigo - non severe
topical fusidic acid - 7 days
treatment of impetigo - severe
oral flucox or clarithromycin + topical fusidic acid
complications of impetigo arise due to what
release of exotoxins A/B that cause desquamation
main complications of impetigo
bullous impetigo, staphylococcus scaled skin syndrome
what is folliculitis
a superficial or deep infection of the hair follicle
what is the causative organism of folliculitis
staph aureus
where can folliculitis be picked up
in hot tubs - likley to pseudomanas
what is the presentation of folliculitis
discrete erythematous papules and pustules on hair bearing sites - itch, boils, furnacle
what is a boil
a deep infection of a single follicle resulting in a large papule
what is a furnicle
a deep infection of multiple follicles resulting in nodule formation
management if folliculitis
usually mild and self limiting - first line BPO + loose clothes for boiles and furnacles oral flucoxacillin
what is cellulitis
acute infection of the skin and soft tissues mainly seen in the legs
what is the causative organism of cellulitis
strep pyogenes +/- staph aureus
presentation of cellulitis
seen in legs, more common in diabetics, macular hot erythema with ill defined margins that is often spreading, associated with malaise, flu like symptoms, leg pain, leg swelling and local lymphadenopathy
diagnosis and management of cellulitis
bacterial swab, oral flucox/doxycyc, if severe IV flucox or vancomycin
what is ersipelas
a superficial form of cellulitis
what is the causative organism of ersipelas
strep pyogenes
presentation fo ersipelas
affects the face, spreading rash, rash is well demarcated erythematous plaque, associated with fever and systemic upset
management of ersipelas
IV flucox
what is scabies
a highly contagious skin infestation caused by sarcoptes scabei
what is the presentation of scabies
severe itch - worse at night, eruthematous papules, vesicles, pustules or nodules with visible skin burrows
location of scabies
web spaces, wrists axillae, umbilicus, buttocks and groin
what is a contagious form of scabies usually seen in the elderly or immunocompromised - associated with hyperkeratotis crusted lesions +/- itch
norwegion scabies
what is the management of scabies
permethrin or malathion over night
presentation of head lice
severe itch + visible eggs in hair
management of head lice
malathion or physical removal with comb
what is lyme disease caused by
a tick bite
where is lyme disease most commonly seen
in europe or USA
what is the causative organism of lyme disease
borrelia durgdorferi
what is the fist presentation of lyme disease
erythema chronicum migrans - BULLS EYE- 2 weeks after bite
second presentation fo lyme disease
6 months after bite - systemic symptos of malaise and arthralgia and firm bluish/red swellings on ears or nipples
third presentation of lyme disease
6 months to 8 years after bite wth bluish discolouration anf atrophy of the skin - systemic symptoms can be variable and include chronic pain
diagnosis of lyme disease
serology
management of lyme disease
remove tick, doxycycline, amoxicillin
