Fungal Infections Flashcards
Three types of Ringworm.
Tinea corporis (skin), Tinea cruris (groin), Tinea capitis (scalp).
First line Ringworm treatment (Corporis and Cruris).
Corporis and Cruris: Topical clotrimazole, econazole, miconazole or Terbinafine for over 12s only. Topical corticosteriods combination for high inflammation.
Ringworm treatment (Corporis and Cruris) if topical fails or immunocompromised.
Oral therapy.
Terbinafine 250mg daily (for 2-4wks Cruris or 4wks Coporis).
Itraconazole 100mg daily for 15day or 200mg daily for 7days.
Tinea Capitis treatment.
Rural: Griseofulvin 1g daily for 8-10wks + 2wks after improvement.
Urban: Terbinafine 250mg daily for 4wks.
Tinea Pedis (Athlete’s foot) First line treatment.
Imidazole cream 2-4wks.
Terbinafine cream 1wk.
Tinea Pedis (Athlete’s foot) if topical treatment fails or severe infection.
Oral:
Terbinafine 250mg daily for 2-6wks.
Itraconazole 100mg daily 30d or 200mg twice daily for 7d.
Griseofulvin – 500mg daily for 4-8wks (and at least two weeks after symptoms resolved).
Causative species of Tinea pedis.
Trichophyton rubrum,
T. mentagrophytes,
Epidermophyon floccosum.
What is Onychomycosis and causative species.
Fungal nail infection. T. rubrum, T. mentagrophytes, E. floccosum, Candida.
Dermatophyte infection first line systemic managment.
Terbinafine 250 daily for 6wks to 3months (finger nails) 3-6months (toe nails).
For candida first line is itraconazole 200mg BD for 7 days then 21 day intervals. 2 pulses for fingernails, 3 for toenails.
Why would you use amorolfine as topical management of Dermatophyte infection.
Mild/superficial disease.
People who can’t take systemic.
Pityriasis versicolor First line treatment.
Topical: Ketoconazole shampoo, Selenium sulphide shampoo, Clotrimazole, econazole, ketoconazole or miconazole creams.
Pityriasis versicolor if First line treatment fails or infection is widespread.
Oral Itraconazole 200mg daily for 7 days
OR fluconazole 50mg daily for 2-4wks.
Oropharyngeal candidia treatment.
1st line- miconazole oral gel 7days.
2nd line- Nystatin suspension 7days.
Oral- 50mg Fluconazole 7-14 days.
Genital candidiasis treatment.
Topical imidazoles (1-3days). Oral intraconazole 200mg BD for 1 day.
Cutaneous candidiasis management.
Skin care advice, topical imidazole, fluconazole 50mg daily for 2-4wks if severe.
Who gets serious fungal infections?
Neutropenic patients (low neutrophil count) - chemo, immunosuppressed.
Intestive care unit patients.
Patients with Central IV catheters.
HIV/AIDs.
Transplant patients (anti-rejection medication).
Long course corticosteriods.
4 types of Candidiasis
Catheter, acute/chronic disseminated, Deep organ.
What is an Aspergilloma.
Growth of fungal ball in pre-existing cavity.
What can the Aspergillus genus lead to.
Pulmonary infection.
What can the Cryptococcus genus lead to.
Pulmonary infection and Invasive CNS disease.
What can the Histoplasma genus lead to.
Histoplasmosis, pulmonary diease and can disseminate.
Types of antifungal.
Azoles (imidazole and triazoles).
Echinocandins (caspofugin and anidulfungin).
Polyenes (amphoterocin).
Nucleoside analogues.
Method of antifungal - Azoles.
Decreased ergosterol biosynthesis in cell membrane by inhibition of fungal CYP450s.
Method of antifungal - Echinocandins.
Inhibiton of beta-1,3-glycan synthesis in cell wall.
Method of antifungal - Polyenes
Ergosterol disruption in cell membrane by creating pores.
Method of antifungal - Nucleoside analogues.
Inhibition of DNA/RNA synthesis in nucleus.
