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Oral Pathology > Fungal Infections > Flashcards

Fungal Infections Flashcards

1
Q

Very common dimorphic yeast; yeast form-commensal/Hyphal form-pathogen; the yeast has the ability to undergo transformation to hyphal form under appropriate conditions, producing germinative or “germ” tubes

A

Candida albicans

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2
Q

Whether candidiasis develops, and the severity of the disease itself, appears to depend on at least 3 factors:

A

host immune status, oral mucosal environment, virulence of the candidal strain

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3
Q

which presentation of candida?: also known as “thrush;” white, curdled milk or cottage cheese-like plaques; buccal mucosa, palate or tongue; may be asymptomatic, but burning or unpleasant taste occasionally noted

A

acute pseudomembranous

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4
Q

which presentation of candida?

A

acute pseudomembranous

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5
Q

which presentation of candida?: usually area of redness, variable borders; tongue is common site; diffuse atrophy of dorsal tongue papillae; particularly after broad-spectrum antibiotics; typically causes “burning” sensation

A

erythematous candidiasis

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6
Q

which presentation of candida:

A

eyrthematous candidiasis

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7
Q

which presentation of candida?: probably referred to as “median rhomboid glossitis” in the past; most are undoubtedly due to chronic candidiasis; well-defined area of redness, mid-posterior dorsal tongue; usually asymptomatic

A

central papillary atrophy (erythematous candidiasis)

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8
Q

which presentation of candida?

A

central papillary atrophy (erythematous candidiasis)

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9
Q

which presentation of candida?: often referred to as “chronic atrophic candidiasis;” denture is often contaminated with candidal organisms, but no invasion of mucosa is seen; erythema of palatal denture-bearing area-typically asymptomatic

A

denture stomatitis (erythematous candidiasis)

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10
Q

which presentation of candida

A

denture stomatitis

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11
Q

which presentation of candida?: also known as “candidal leukoplakia;” white patch that cannot be rubbed off; often ssen on anterior buccal mucosa; may be problematic because a true leukoplakia may have candidiasis superimposed on it; should resolve with antifungal therapy

A

hyperplastic candidiasis

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12
Q

which presentation of candida

A

hyperplastic candidiasis

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13
Q

usually related to candidiasis, but may have other cutaneous bacterial microflora admixed; redness, cracking of corners of mouth, often waxes and wanes; may require topical (Hydrocortisone and iodoquinol cream) or systemic antifungal therapy

A

angular cheilitis

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14
Q
A

angular cheilitis

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15
Q

in almost all cases of candidiasis, the candidal hypae never pentrate deeper than the _ layer

A

keratin

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16
Q

Imidizote antifungal agent; no significant systemic absorption or side effects; pleastant-tasting lozenges (troche); disadvantage-should be dissolved in mouth 5x per day

A

clotrimazole (mycelex)

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17
Q

developed during the 1950s-still effective; not absorbed systemically-must be in contact with the organism in order to be effective; disadvantages: taste (bitter to many) and multiple dosing schedule

A

nystatin (mycostatin)

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18
Q

triazole antifungal agent; readily absorbed-no significant degree of side effects; daily dosing in convenient; relatively expensive

A

fluconazole (diflucan)

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19
Q

recently approved for topical use in the US, but tastes bitter; IV form is used to treat life-threatening systemic candidal (and other fungal) infections; nephotoxicity is significant

A

amphotericin B (fungizone)

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20
Q

approved for treating histoplasmosis and blastomycosis; well-abosorbed; daily dosing; minimal side effects; quite expensive

A

intraconazole (sporanox)

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21
Q

Endemic to Mississippi and Ohio River valleys; 500,000 new cases in US annually; spores in soil contaminted with bird or bat droppings

A

histoplasmosis (Histoplasma capsulatum)

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22
Q

Histopasmosis: most are _ - calcified hilar nodes

A

asymptomatic

23
Q

_ histoplasmosis: may have flu-like illness (fever, headache, myalgia)

A

acute

24
Q

_ histoplasmosis: similar to TB (fever, cough, weight loss, chest pain, hemoptysis) with lung infiltrates seen on radiograph

A

chonic

25
Q

_ histoplasmosis: elderly or immunosuppressed

A

disseminated

26
Q

calcified hilar nodes seen in _

A

histoplasmosis

27
Q

Oral lesions of _: usually seen in disseminated form; chronic variable painful ulcer; clinically indistinguishable to malignancy

A

histoplasmosis

28
Q
A

disseminated histoplasmosis

29
Q

Histoplasmosis best visualized by _ stain or _

A

silver stain or PAS

30
Q

disseminated histoplasmosis - mortality rate of _% if untreated

A

90

31
Q

similar geographic range as histoplasmosis; not very common; marked male predilection (9:1)

A

blastomycosis (Blastomyces dermatitidis)

32
Q

Most are aysmptomatic; caused by inhalation of spores; acute-pneumonia-like illness; chronic-fever, night sweats, cough, weight loss

A

Blasto

33
Q

skin lesions disseminated from lungs; erythematous nodules that enlarge and become verrucous or ulcerated

A

blasto

34
Q
A

blasto

35
Q

hematongenous spread or direct inoculation; irregular, ulcerated surface; clinically resemble malignancy

A

blasto

36
Q

direct inoculation case of _

A

blasto

37
Q

large yeasts; pseudoepitheliomatous hyperplasia; granulomatous or mixed inflammatory response

A

blasto

38
Q

endemic to desert Southwest US; 100,000 people annually infected; “Valley fever” - in combo with the hypersensitivity rxn erythema nodosum

A

coccidioidomycosis (Coccidioides immitis)

39
Q

Inhalation of spores; flu-like illness in 40% of affected pts; chronic progressive pulmonary form resembling TB; disseminated in <1%; skin of central face may be affected; oral lesions are rare

A

coccidoido

40
Q
A

coccidioido

41
Q

large spherules with granulomatous and/or neutrophilic response

A

coccidioido

42
Q

organism lives in gut of pigeon (yeast is found in both soil and tissues); air-borne spores; affect immunosuppressed almost exclusively

A

cyrptococcosis (Cryptococcosis neoformans)

43
Q

flu-like symptoms; disseminates to meninges, followed by headache, vomiting, neck stiffness; cutaneous lesions may develop in 10-15%; oral lesions are rare

A

crypto

44
Q

granulomatous inflammation; yeast with clear halo

A

crypto

45
Q

crypto: visualized with _, PAS, silver stains

A

mucicarmine

46
Q

antigen detection in cerebrospinal fluid

A

crypto

47
Q

crypto treatment: amphotericin B plus _

A

flucytosine

48
Q

several genera of molds (Mucor, Rhizopus, Absidia); severe diabetic or immunocompromised patient

A

zygomycosis

49
Q

_ zygomycosis is the form seen in the oral region

A

rhinocerebral

50
Q

nasal obstruction, bloody nasal discharge; facial pain, swelling, palatal perforation; black, necrotic lesions; opacification of sinuses; visual disturbances, blindness; seizures and death eventually

A

zygomycosis

51
Q
A

zygomycosis

52
Q

large, branching hyphae; extensive necrosis; hyphae within blood vessels; diagnosis based on biopsy

A

zygomycosis

53
Q
A

Oral Pathology (11 decks)

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