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Year 2- Infectious Disease > Fungal Infections > Flashcards

Fungal Infections Flashcards

1
Q

Fungal infections are described as being pooutunistic, what does this mean?

A

They tend to thrive when the patient’s immune systems are weaker

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2
Q

When may a patient have a weaker immune system and be at increased risk of a fungal infcetion?

A

Primary immunodeficiency
HIV/AIDS
Malignancy and transplants
Premature neonate

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3
Q

Another group of patients at risk of fungal infections are those with chronic lung conditions.

Which type of fungal infection may affect them?

A

Inhalation of fungi e.g. mould

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4
Q

What are the tow main types of fungal skin infection?

A

Candidiasis
Tinea

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5
Q

What is Candidiasis?

A

Yeast like infection
Uniform commensal of mouth/GIT
Opportunistic

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6
Q

What is tinea?

A

Superficial skin infection caused by dermatophytes

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7
Q

Candida is asymptomatic until when?

A

Until disrupted e.g. in lowering of the immune system or disrupted mucosal barriers

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8
Q

What are some of the risk factors for candida infection?

A

Moist areas
Skin folds
Obesity
Diabetes
Neonates
Pregnancy
Poor hygiene
Occupation in wet environments

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9
Q

Patients who have recently had which drug may be more likely to develop a Candida infection?

A

Patients on broad spectrum antibiotics

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10
Q

What type of rash is common in babies?

A

Nappy rash aka napkin dermatitis

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11
Q

What is genital candidiasis often known as?

A

Thrush

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12
Q

What are the symptoms of thrush?

A

Itch
Soreness and burning discomfort
Vulval oedema
Cottage cheese/white curd discharge
Bright red rash

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13
Q

What are some risk factors of thrush?

A

Just before and during menstruation
Obesity
Diabetes
Iron deficiency anaemia
Immunodeficiency
Recent course of broad spectrum antibiotics
High dose OCP/ oestrogen based HRT
Pregnancy

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14
Q

How is a diagnosis of thrush made?

A

Clinically but vaginal swab can be done

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15
Q

What is the management of thrush?

A

Clotrimazole - topical antifungal cream
Oral fluconazole
Supportive measures e.g. loose clothing, avoiding soap

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16
Q

What is non-specific balanitis?

A

Inflammation of the glans penis

->bacterial or candida infection

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17
Q

Treatment of candida balanitis?

A

Topical clotrimazole

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18
Q

What are the risk factors for oral candidiasis aka oral thrush?

A

Extremes of age
Immunocompromised
Diabetes
Dental prosthesis
Smoking
Poor oral hygiene
Local trauma
Nutritional deficiency
Impaired salivary function

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19
Q

Which two types of drugs increase risks of oral thrush?

A

Broad spectrum antibiotics
Inhaled or oral corticosteroids

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20
Q

What are the symptoms of oral thrush?

A

White or yellow plaques in mouth
Mild burning
Erythema
Altered taste
‘Furry tongue’

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21
Q

What is the management of oral thrush?

A

Topical antifungal e.g. nystatin or miconazole gel
Smoking cessation
Good oral hygeine

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22
Q

Systemic candida infections can occur in the immunosuppressed. Who would fall into this catergory?

A

Those with HIV, malignancy or those having chemo

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23
Q

What are some other risks of systemic candida infection?

A

Recent abdominal surgery
Renal failure
Low birth weight infants
Neutropoenia
Diabetes

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24
Q

Candidaemia?

A

Candida infection in the bloodstream

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25
Q

Systemic candida infection can spread to any body part.

When should you be clinically suspicious of a systemic candida infection?

A

Fever which doesn’t respond to antibiotics

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26
Q

Invasive candidiasis?

A

Gut commensal, common bloodstream infection

27
Q

How is a diagnosis of invasive candidiasis made?

A

Blood cultures

28
Q

What is the treatment of invasive candidiasis?

A

IV/oral antifungals

29
Q

What is tinea caused by?

A

Direct spread from infected individual or animal
Indirect spread by clothing or bedding etc

30
Q

What are some risk factors of tinea?

A

Hot humid environments
Obesity
Tight fitting clothing
Immunocompromised
Hyperhidrosis (excess sweating)

31
Q

How do tinea infections usually present?

A

Scaly itchy skin

32
Q

Upon examination of a tinea infection, what would be seen?

A

Single or multiple flat or slightly raised patches

Typically central clearing

Asymmetrical distribution

33
Q

Investigations are not usually required for tinea infections but would could be done if unsure?

A

Skin flaking or swab

34
Q

List some common types of tinea infection.

A

Athlete’s foot
Ringworm
Tinea Capitis (scalp and hair)

35
Q

What is the management of tinea infections?

A

Supportive e.g. loose fitting clothing, good hygiene
Topical anti-fungal creams

36
Q

How can a diagnosis of fungal nail infection by made?

A

Nail clippings to send off

37
Q

What are the management options for fungal nail infections?

A

Can just be left
Keep nails trimmed and have well fitting shoes
Cotton absorbent socks
Topical nail lacquer
Oral terbinafine

38
Q

If a patient in on oral terbinafine, what needs to be monitored?

A

LFTs

39
Q

Aspergillus?

A

A type of mould

40
Q

Where can aspergillus be found?

A

Soil, compost, other organic matter
Dust and bedding
Damp buildings
Air conditioning systems

41
Q

How is aspergillus transmitted?

A

Inhalation by spores

42
Q

Inhalation of aspergillus can be harmful to those with which underlying health conditions?

A

Cystic fibrosis
COPD
TB
Sarcoidosis
Weakened immune syste,

43
Q

What does aspergillus cause?

A

Aspergillosis

44
Q

What are the symptoms of Aspergillosis?

A

Cough
SOB
Wheeze
Pyrexia
General malaise
Headache

45
Q

What are the four types of aspergillosis?

A

Allergic bronchopulmonary aspergillosis
Chronic pulmonary aspergillosis
Aspergilloma
Invasive pulmonary aspergillosis

46
Q

Which type of aspergillosis is most common in patients with asthma and cystic fibrosis?

A

Allergic bronchopulmonary aspergillosis

47
Q

What is allergic bronchopulmonary aspergillosis due to?

A

Allergy to aspergillus mould

48
Q

What are the symptoms of allergic bronchopulmonary aspergillosis?

A

Cough > 3 weeks

49
Q

What can allergic bronchopulmonary aspergillosis lead to?

A

Pulmonary fibrosis

50
Q

How can a diagnosis of allergic bronchopulmonary aspergillosis be made?

A

Bloods
Sputum culture
Positive skin test
Positive serology
CXR/CT

51
Q

What is the management of allergic bronchopulmonary aspergillosis?

A

Oral long term high dose prednisolone
Antifungal treatment

52
Q

Chronic pulmonary aspergillosis means symptoms have been ongoing for > 3 months.

Which type of patients does it affect?

A

Patients with underlying lung conditions

53
Q

How can chronic pulmonary aspergillosis present?

A

Exacerbations not responding to antibiotics
Decline in lung function
Increased resp. symptoms

54
Q

How is a diagnosis of chronic pulmonary aspergillosis made?

A

Sputum culture
Refer for CXR

55
Q

What is used in the management of chronic pulmonary aspergillosis?

A

Oral anti-fungals

56
Q

Aspergilloma?

A

Fungal mass which grows in lung cavities

57
Q

Who is at risk of an aspergilloma?

A

Patients with:
TB
Sarcoidosis
Bronchiectasis
After pulmonary infection
Bronchial cyst or bullae

58
Q

How does aspergilloma present?

A

Commonest presentation is haemoptysis
Cough and fever sometimes

Can be asymptomatic and only picked up on CXR

59
Q

Who is at risk of acute invasive pulmonary aspergillosis?

A

Neutropenic patients
Post transplant patients
Patients w defects in phagocytes

60
Q

How can acute invasive pulmonary aspergillosis present?

A

Any organ can be involved so symptoms vary but:

Cough
SOB
Fever
Haemoptysis
Pleuritic chest pain
Nasal congestion and pain, sinusitis can develop

61
Q

How can acute invasive pulmonary aspergillosis spread?

A

Haematogenously

-> can spread to kidneys, brain, GIT, skin, eyes so presentation varies
High mortality rate 50%

62
Q

What is the management of acute invasive pulmonary aspergillosis?

A

IV anti-fungals

63
Q
A

Year 2- Infectious Disease (12 decks)

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