Fungal Infections Flashcards
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
Candida albicans
Whether candidiasis develops, and the severity of the disease itself, appears to depend on at least 3 factors:
host immune status, oral mucosal environment, virulence of the candidal strain
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
acute pseudomembranous
which presentation of candida?
acute pseudomembranous
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
erythematous candidiasis
which presentation of candida:
eyrthematous candidiasis
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
central papillary atrophy (erythematous candidiasis)
which presentation of candida?
central papillary atrophy (erythematous candidiasis)
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
denture stomatitis (erythematous candidiasis)
which presentation of candida
denture stomatitis
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
hyperplastic candidiasis
which presentation of candida
hyperplastic candidiasis
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
angular cheilitis
angular cheilitis
in almost all cases of candidiasis, the candidal hypae never pentrate deeper than the _ layer
keratin
Imidizote antifungal agent; no significant systemic absorption or side effects; pleastant-tasting lozenges (troche); disadvantage-should be dissolved in mouth 5x per day
clotrimazole (mycelex)
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
nystatin (mycostatin)
triazole antifungal agent; readily absorbed-no significant degree of side effects; daily dosing in convenient; relatively expensive
fluconazole (diflucan)
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
amphotericin B (fungizone)
approved for treating histoplasmosis and blastomycosis; well-abosorbed; daily dosing; minimal side effects; quite expensive
intraconazole (sporanox)
Endemic to Mississippi and Ohio River valleys; 500,000 new cases in US annually; spores in soil contaminted with bird or bat droppings
histoplasmosis (Histoplasma capsulatum)
Histopasmosis: most are _ - calcified hilar nodes
asymptomatic
_ histoplasmosis: may have flu-like illness (fever, headache, myalgia)
acute
_ histoplasmosis: similar to TB (fever, cough, weight loss, chest pain, hemoptysis) with lung infiltrates seen on radiograph
chonic
