fungal infections Flashcards
What does it mean for fungal infections to be opportunistic
They thrive when the patients immune system is weak
What are the main types of fungal skin infection
candidiasis - yeast like infection and is a uniform commensal of the mouth and the GI tract
tinea - superficial skin infection caused by dermatophytes
What are the risk factors for candida
moist areas, skin folds, obesity, recent broad sprectrum antibiotics
What is intertrigo
type of candida which occurs in skin folds
What is napkin dermatitis
compromised skin barrier due to friction or prolonged contact with urine or faeces
What are the symptoms of genital candidiasis
itch
soreness
dysuria
white curd discharge
bright red discharge
How is genital candidiasis (vaginal thrush) diagnosed
clinically and vaginal swab
What is teh treatment for genital candidiasis
Clotrimazole - topical anti-fungal cream
Oral flucloxacillin 2nd line
What is non-specific balanitis
inflammation of glans penis which is caused by bacteria or candida
What is the treatment of non specific balanitis
topical clotrimazole
What are risk factors for oral candidiasis
old age or young age
broad spectrum antibiotics
inhaled or oral corticosteroids
What are the symptoms of oral candidiasis - oral thrush
white or yellow plaques in the mouth
burning feeling
erythema
dysphagia
What is the management of oral candidiasis
topical antifungal - nystatin or miconazole gel
Fluconazole if the thrush is further down
What is the treatment for invasive candidiasis
IV/Oral antifungals
How is tinea spread
Direct or indirect contact with infected animal or person
What is the main risk factor for tinea
Sweaty humid environments
How does tinia present
scaly itch skin
raised annular patches
asymmetrical distribution
How is tinea diagnosed
clinically or skin scrapings or swab
What is the treatment for tinea
topical antifungal cream:
Terbinafine
clotrimazole
miconazole
If extensive give oral terbinafine
What can terbanifine cause in blood results
altered lFTs
What is the treatment for nail fungal infection
oral terbinafine for 6-12 weeks for fingers and 3-6 months for toenails
What is aspergillus
type of mould found in soil, dust and bedding
How is aspergillus transmitted
inhalation of spores
Who is at risk of aspergillus
People with chronic respiratory conditions or immunosuppressed
What are the symptoms of aspergilluosis
cough
SOB
wheeze
pyrexia
malaise
headache
Who is allergic bronchopulmonary aspergillosis most common in
asthma and cystic fibrosis
How does allergic bronchopulmonary aspergillosis present
cough for longer than 6 weeks
How is allergic bronchopulmonary aspergillosis diagnosed
bloods
sputum culture
positive skin test
positive serology
xray of chest and CT
What is the treatment for aspergillosis
Oral long term high dose oral prednisolone as well as antifungal - itraconazole
How does chronic pulmonary aspergillosis present
cough for more than 3 months
exacerbation not responding to antibiotics
What is the treatment for chronic pulmonary aspergillosis
oral anti-fungals
What is aspergilloma
fungal mass which grows in lung cavities
how does a aspergilloma present
Haemoptysis - common
cough and fever
How is an aspergilloma diagnosed
CXR - CT scan
What is the treatment for aspergillomas
surgical resection and long term antifungals
Who is at risk of acute invasive pulmonary aspergillosis
neutropenic - low WBC
post transplant
defects in phagocytes
How does acute invasive pulmonary aspergillosis present
cough
SOB
fever
haemoptysis
pleuritic chest pain
congestion and sinusitis
What is the management of acute invasive pulmonary aspergillosis
IV antifungals
