Fungal Infections

Question 1

the most common fungal infection; an opportunistic infection; yeast form- commensal; hyphal form-pathogen; ability of yeast to undergo transformation to hyphal form under appropriate conditions, producing germinative or “germ” tubes

Answer 1

Candidiasis

Question 2

The best recognized form of candidal infection; white, curdled milk or cottage cheese-like plagues; buccal mucosa, palate or tongue; mild burning sensation/unpleasant taste

Answer 2

acute pseudomebraous candidiais (thrush)

Question 3

Also known as “candidal leukoplakia”; white patch that cannot be rubbed off; anterior buccal mucosa; leukoplakia associated with candida: red and white lesions-> speckled leukoplakia; complete resolution of the lesion after antifungal therapy

Answer 3

chronic hyperplastic candidiasis

Question 4

An erythematous candidiasis; tongue as the common site; diffuse atrophy of dorsal tongue papillae, particularly after broad-spectrum antibiotics; antibiotic sore mouth; typically causes “burning” sensation

Answer 4

acute atrophic candidiasis

Question 5

Denture stomatitis; denture is contaminated with candidal oragnisms; seldom penetration of candidal hyphae into the keratin layer; erythema of palatal denture-bearing are-typically asymptomatic

Answer 5

chronic atrophic candidiasis

Question 6

Red, fissured lesions, irritated, raw feeling; candidiasis, but may have cutaneous bacteria (S aureus) admixed; waxes and wanes; may require topical or systemic antifungal therapy; if lips involvement: cheilocandidiasis

Answer 6

angular cheilitis (perleche)

Question 7

Referred to as “median rhomboid glossitis” in past; most are due to chronic candidiasis; well-defined area of redness, mid-posterior dorsal tongue; usually asymptomatic

Answer 7

central papillary atrophy

Question 8

Associated with lip-licking or chronic use of petrolatum-based materials

Answer 8

perioral candidiasis or candidal cheilitis

Question 9

Patient will have angular cheilitis, central papillary atrophy and a “kissing lesion” of posterior hard palate

Answer 9

multifocal oral candidiasis

Question 10

associated with specific immunologic defects related to how the body interacts with candida albicans

Answer 10

chronic mucocutaneous candidiasis

Question 11

hyperparakeratosis; elongation of rete ridges; chronic inflammatory cell infiltrate; spongiotic pustules (superficially); candidal hyphae, never penetrate deeper than the keratin layer

Answer 11

candidiasis

Question 12

IV form is used to treat life-threatening systemic candidal infections: nephrotoxicity is significant

Answer 12

amphotericin B

Question 13

Most common systemic fungal infection in the US; Endemic to Ohio and Mississippi River valleys; Dimorphic; spore in bird or bat droppings->inhale->lung->germinate

Answer 13

histoplasmosis (H. capsulatum)

Question 14

Most cases aymptomatic: calcified hilar lymph nodes seen coincidentally; acute: flu-like illness, self limited; chronis: cavitary pulmonary lesions, similar to TB; disseminated: seen in elderly, debilitated, or immunocompromised, many organs affected

Answer 14

histoplasmosis

Question 15

usually with disseminated disease; tongue, palate, buccal mucosa; painful ulceration, erythematous or white with an irregular surface or ulcers with firm/rolled margins, similar to malignancy; granulomatous inflammation

Answer 15

histoplasmosis

Question 16

Opportunistic fungal infection second in frequency to candidiasis: spectrum of disease: allergy, localized infection or invasive aspergillosis; spore (in soil, water, decaying organic debris)->inhale

Answer 16

aspergillosis

Question 17

Features vary, depending on immune status and extent of tissue invasion; low grade infection in maxillary sinus->antrolith (radiopaque); after tooth extraction or endo->painful gingival ulceration; disseminated in immunocompromised patient (most commonly in post transplant immunosuppressive therapy)

Answer 17

aspergillosis

Question 18

uncommon fungal infection; in patients with AIDS and most common life threatening fungal infection in patients with AIDS; in excreta left by birds; asymptomatic infection of the lungs (primary); dissemination to meninges, skin (including head and neck), bone, prostrate

Answer 18

cryptococcosis (cryptococcus neoformans)

Question 19

also known as mucormycosis and phycomycosis; several genera of molds; opportunistic, fulminant fungal infection; affects severe diabetic or immunocompromised patient; rhinocerebral form in oral region

Answer 19

zygomycosis

Question 20

Nasal obstruction, bloody nasal discharge, focal pain/headache; facial swelling, cellulitis, visual disturbances, proptosis; cranial nerve involvement; maxillary sinus involvement, swelling of the palate; ulcer, necrosis; opacification of the sinus as patchy effacement of the bony walls of the sinus; similar to malignancy of the sinus area

Answer 20

zygomycosis

Question 21

Large, branching, nonseptate hyphae with extensive tissue necrosis

Answer 21

zygomycosis