Fungal Infections Flashcards
Tinea Versicolor
AKA Pityriasis Versicolor Common superficial skin infxn Caused by Malassezia furur Very common in teens and young adults Heat, humidity, excessive sweating
Tinea versicolor presentation
Velvety tan, pink or white macules
Hypopigmented areas that do not tan
Trunk, upper arms, neck and groin
Lesions may scale if scraped
Skin scrapings from tinea versicolor show?
Spaghetti and Meatballs
Tinea Versicolor TOC
Selenium Sulfide lotion once daily for 7 days
___% of cases will have recurrence within 2 years.
80%
Tinea Infections
Located in stratum corneum
Caused by dermatophytes
Dermatophytes digest?
Keratin
Scaling, nails thicken and crumble, hair loss
Tinea Corporis
Face, limbs and trunk Ring shaped lesion with well demarcated margins Central clearing Scaly, erethematous border Transmitted by contact
Tinea corporis Tx
Topical azole
1-2 daily for 2-4 weeks
Tinea Cruris
Groin, inguinal folds
SPares the scrotum
Pruritis with burning
Tx with topical azole
Tinea Pedis
Interdigital scaling, maceration
DIffuse scaling of soles of feet
Acute vesicular lesions
Tx: topical azole
Tinea Capitis
most cases in children
Inflamed, scaly patches
Tender, pustular nodules
Tinea capitis Tx
Griseofulvin for 8 weeks
Tinea Unguium
Typically toenails but can affect fingernails
Moves distal to proximal
Usually asymptomatic
Tinea Ungiuim Tx
oral Itraconazole for 12 weeks
Candidiasis Intertrigo
Axillae, under breasts, groin, intergluteal folds
Candidiasis Paronychia
Nail folds
Candidiasis Balantitis
Gland penis
Thrush
Mouth and tongue
Candidiasis folliculitis
Follicular pustules
Tx for Thrush
Nystatin
Clotrimazole
Tx for cutaneous Candidiasis
Nystatin powder for macerated areas
Clotrimazole (Lotrimin)
Systemic Candidiasis
Positive blood cultures 50% of time
IV antifungal such as fluconazole
Fundoscopic exam
Histoplasma Capsulatum
Found in soil from bird or bat droppings Endemic in river valleys Inhalation of spores Spread to other organs (by lymph) Can be acute and severe
Chronic Pulmonary Histoplasmosis
Older patients
Underlying chronic lung disease
CXR: apical cavities, infiltrates, nodules
Disseminated Histoplasmosis
Multisystem involvement Similar to septic shock Fever, dyspnea, weight loss Ulcers in oropharynx Can be fatal in 6 weeks or less
Disseminated Histoplasmosis CXR findings
Miliary pattern
Disseminated Histoplasmosis Tx
Refer to ID specialist
Itraconazole 200-400mg BID for weeks to months
Coccidioidomycosis
Secondary infection from inhaling molds
AKA valley fever
More severe in immunocompromised
Can disseminate and become severe
Coccidioidomycosis Rash
Erythema Nodosum
occurs 2-20 days after onset of respiratory symptoms
Coccidioidomycosis Tx
Amphotericin B IV
Oral Azoles
Cryotpcoccosis
Caused by cryotpcoccus neoformans
Yeast found in soil and pigeon poop
Most common cause of fungal meningitis
Rare in immunocompetent persons
Cryotpcoccosis S/S
Can lead to respiratory failure
Any organ can be affected
CNS predominates: HA, confusion, mental status changes
Cryotpcoccosis Tx
Refer
Amphotericin B IV x 2 weeks
followed by
Fluconazole x 8 wks
Aspergillosis
Aspergillosis fumigatus
Found everywhere in nature
Tissue invasion can occur
Aspergillosis S/S
Allergy Airway or lung invasion (most common) -fever, chest pain, SOB, cough, hemoptysis Cuteneous Can disseminate everywhere else
Aspergillosis Tx
Antifungals and glutocorticoids
When will you see an india ink prep?
Cryptococcosis
Halo sign =
Aspergillosis
