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infectious disease > fungal infections > Flashcards

fungal infections Flashcards

1
Q

risk factors for fungal disease

A

dampness
poor circulation
post menopause
suppressed immune system
nail and skin injury
Abx use
low vitamin D
DM

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2
Q

dry and scaly

A

tinea

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3
Q

moist and beefy

A

candida

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4
Q

superficial fungal infection of the skin caused by dermatophytes trichophyton

A

tinea infections

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5
Q
  • pt notices a balding patch
    -dry crusting scalp
    -dry,flaking well defined around plaque like lesion
A

tinea capitis

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6
Q

tinea capitis treatment

A

oral terbinafine (kids per 4)
griseofulvin (kids over 2)

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7
Q

-inflamed dry patches/plaques within the beard
-may itch
-may have yellow crusting
-tender

A

tinea barbae

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8
Q

tinea barbae treatment

A

oral terbinafine, griseofulvin,flucanoazole

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9
Q

-often from infected pet
-itchy
-annular lesion with advancing scaly border and central clearing

A

tinea corporis

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10
Q

tinea corporis prevention

A

-treat infected pets
-use foot powder
-keep feet dry
-wear clean socks

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11
Q

tinea corporis treatment

A

topical terbinafine

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12
Q

-itching of skin of genitals, inner thighs and buttock
-intertriginous areas
-burning sensation
-annular shaped erythematous lesions with raised scaly borders and a clear center

A

tinea cruris (jock itch)

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13
Q

tinea cruris (jock itch) prevention

A

miconazole nitrate drying powder for excessive perspiration or protection of skin folds

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14
Q

tinea cruris (jock itch) treatment

A

topical terbinafine

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15
Q

-most often presents with asymptomatic scaling
-may progress to fissuring or maceration in toe web spaces
-itching, burning
-scaling palms and soles

A

tinea pedis (athletes foot)

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16
Q

tinea pedis treatment (macerated stage)

A
  1. aluminum acetate (domeboro) solution soak
  2. PLUS topical cream (azoles or ciclopirox)
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17
Q

-thickened yellow brittle deformed nail
-possible loss of nail or partial nail

A

onychomycosis

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18
Q

tinea pedis treatment (dry and scaly stage)

A

any broad spectrum antifungal cream

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19
Q

how to confirm onychomycosis

A

clipping

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20
Q

onychomycosis treatment (toenail)

A

Terbinafine

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21
Q

-velvety,tan,pink,or white macule that do not tan with sun exposure
-fine scales that are not visible but are seen by scraping the lesion
-young adults/teenagers
-central upper trunk
-spaghetti and meatballs seen under microscope (KOH)

A

tinea versicolor

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22
Q

tinea versicolor treatment

A

oral fluconazole 300mg 14 days apart

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23
Q

-typically a noninvasive yeast that can be found in stool,urine,mouth,genitalia,skin
-normal part of GI and GU microbiota

A

candidiasis

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24
Q

risk factors for candidiasis

A

-Abx
-IV/inhaled/oral steroids
-DM
-burns
-IV/Foley catheter

25
Q

-itching, burning/sore throat
-dysphagia/odynophagia
-possible pain at sides of lips
-thick,white plaques on the tongue or oropharyngeal mucosa
-beefy red appearance

A

candidiasis oropharyngeal

26
Q

hallmark of candidiasis

A

white plaques that bleed easily and can be scraped away with a tongue depressor (it is friable)

27
Q

candidiasis oropharyngeal treatment

A

fluconazole
ketoconazole
nystatin mouth rinse

28
Q

-cracked lips
-red swollen corners of the mouth
-white patches*

A

candidiases cheilitis

29
Q

how to diagnose candidiases cheilitis

A

clinical

30
Q

-common
-white discharge, itching, irritation, dysuria, dyspareunia
-risk factors: Abx, intercourse, pregnancy, oral contraceptives, DM

A

vulvovaginal candidiasis

30
Q

candidiases cheilitis treatment

A

nystatin, ketoconazole, clotrimazole

31
Q

how to diagnose vulvovaginal candidiasis

A

swab of vaginal sidewall and discharge

32
Q

vulvovaginal candidiasis treatment

A

single dose fluconazole

33
Q

-itching around the glans penis
-red,swollen foreskin/glans penis
-possible white discharge around the glans penis

A

balanitis

34
Q

balanitis treatment

A

topical nystatin ointment

35
Q

-skin condition caused by maceration of skin due to heat, moisture, and friction
-irritating agents
-in skin folds
-exposure to urine,feces,sweat
-pruritic
-stinging burning
-beefy red rash
-WATCH for secondary bacterial infection

A

intertrigo

36
Q

intertrigo treatment

A

-good hygiene
-keep dry
-drying powders
-topical antifungal (imidazole or clotrimazole with hydrocortisone)

37
Q

-usually in patients with indwelling catheter
-fever,chills
-dysuria,urgency,hesitancy
-flank or abdominal pain

A

candidal cystitis: funguria

38
Q

how to diagnose candidal cystitis

A

urine analysis: should contain yeasts or pseudohyphae

39
Q

candidal cystitis treament

A

usually resolves with discontinuance of Abx or removal of bladder catheter

40
Q

persistant symptomatic funguria treatment

A

PO fluconazole

40
Q

-immunosuppressed pts
-substernal odynophagia
-gastroesophageal reflux
-pts may have thrush, but not always

A

esophageal candidiasis

41
Q

how to diagnose esophageal candidiasis

A

by endoscopy with biopsy and culture

42
Q

esophageal candidiasis treatment

A

If patients can swallow: fluconazole
severe illness/inability to swallow: IV fluconazole

42
Q

-inhaled fungi found in soil from bat and bird droppings
-most prevalent endemic mycosis in north america
-ohio and Mississippi River valley
-eastern Canada,mexico,central America,south America,africa,southeast asia
-soil, humidity, and acidity

A

histoplasmosis

43
Q

hallmark of histoplasmosis

A

activities that stir up dirt: plowing soil, spelunking (cave exploring), excavation,demolition of old homes, cleaning chicken coops, bats

44
Q

histoplasmosis labs

A

combination of first morning urine and serum polysaccharide antigen assays has 83% sensitivity for diagnosis of acute pulmonary histoplasmosis

45
Q

histoplasmosis treatment

A

mild/moderate: itraconazole
severe: IV amphotericin B

46
Q

-rare disease thought to be a result of an abnormal immunologic response to antigens released by histoplasma capsulatum

A

fibrosing mediastinitis

47
Q
  • most common cause of fungal meningitis
    -frequently found in soil and bird feces
    -inhaled
    -pulmonary symptoms
    -can be simple nodules or widespread infiltrates and respiratory failure
A

cryptococcosis

48
Q

how to diagnose cryptococcosis

A

-culture of respiratory secretions or pleural fluid
-lumbar puncture for suspected CSF involvement
-chest xray and CT show a solitary pulmonary nodule

49
Q

-coccidioides immitis or C. posadasii
-fungus that inhabits arid soil of the southwestern US (California, Arizona)***
-an opportunistic organism in immunosuppressed patients
Primary:
-fever,chills,HA,body aches
-erythema nodosum

A

coccidiodomycosis (valley fever)

50
Q

hallmark of coccidiodomycosis (valley fever)

A

soil of southwestern US (California,arizona)

51
Q

coccidiomycosis labs

A

CBC- leukocytosis and eosinophilia
ELISA- IgM antibodies
CSF- lymphocytosis, reduced glucose, complement fixing antibodies

52
Q

coccidioidomycosis treatment

A

symptomatic for limited disease

with progression–> itraconazole or fluconazole

53
Q

-inhaled and most commonly infects the pulmonary tissue
-usually occurs in immunocompetent individuals who work outside**
-outdoor activities
-abrupt onset fever, chills,body aches
-pleuritic chest pain
-cough: productive or nonproductive

A

blastomycosis

54
Q

blastomycosis labs

A

-CBC: leukocytosis, anemia
-grows readily in culture
-organism found in expectorated sputum or tissue biopsy
-lobar consolidation*

54
Q

blastomycosis treatment

A

mild/moderate: itraconazole
sever: IV amphotericin B

infectious disease (13 decks)

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