Fungal infections Flashcards
Cutaneous fungal infections
- definition
- pathogenesis
- risk factors
- skin fungal infection - epidermomycosis caused by dermatophytes
- fungi that infect keratinized tissue - they metabolize keratin on skin, nails, hair
- diabetes mellitus, immunodeficiency, poor circulation, peripheral arterial disease, maceration of skin
Cutaneous fungal infections
- classification (5)
- diagnosis (3)
- treatment
- prevention
- tinea corporis (ringworm), tinea pedis, tinea manuum, tinea cruris, tinea capitis
- KOH preparation, Wood’s light examination (green fluorescent microsporium species), fungal culture
- topical anti-fungal (terbinafine or azoles), except tinea capitis (systemic treatment is necessary)
- systemic anti-fungal - terbinafine, griseofulvin
-avoid contact with contaminated animals, humans or objects
Cutaneous fungal infections
-clinical features
Tinea corporis - initially round, pruritic, erythematous plaque growing centrifugally. Develops into pruritic, round plaque with central clearing and scaling, raised border
Tinea pedis - interdigital (pruritic, erythematous scaling and erosions between toes), moccasin (hyperkeratotic thickening on soles), vesicular (pruritic or painful vesicular lesions and erythema)
Tinea manuum - pruritic, scaly, hyperkeratotic, centrifugally growing, erythematous lesions
Tinea cruris - pruritic erythematous plaque growing centrifugally with scaling and raised border, spares scrotum
Tinea capitis - round, pruritic scaly plaques with broken hair shafts or alopecia in affected area. Kerion is a severe form with pustule formation
Tinea capitis
- “grey patch infection”
- “black dot infection”
- “kerion”
- microsporium
- superficial trichophyton
- deep trichophyton infection
Onychomycosis
- definition
- etiopathogenesis
- subtypes
- fungal infection of the nail
- dermatophytes (toe nail), yeast fungi (hand nail), mold fungi
- distal-lateral subungual, white superficial, proximal subungual, total dystrophic
Onychomycosis
-clinical features (4)
- nail discoloration
- subungual hyperkeratosis
- onycholysis - separation of nail from nail bed
- onychomadesis - total loss of nail plate
Onychomycosis
- diagnosis
- treatment
- prevention
- microscopy and culture
- removal of infected nail mass (topical keratolytic - salicylic acid), topical treatment (terbinafine, ketoconazole), systemic treatment (fluconazole)
- separate hygiene tools and disinfection of it
Cutaneous candidiasis
- definition
- types (3)
- etiopathogenesis
- risk factors
- fungal infection of skin
- diaper, intertrigo (skin folds), interdigital
- C. albicans
- imbalance of local flora –> overgrowth of C.albicans
- systemic –> invasion of bloodstream –> disseminated organ infection
-immunosuppression, imbalance in local flora (antibiotics, increased estrogen levels), compromised skin, wet/warm environments, tight diapers
Cutaneous candidiasis
-clinical features
Diaper - redness, scaling, erosions, papules, pustules
Intertrigo - redness, scaling, erosions, papules, vesicles, itching
Interdigital - redness, scaling, erosions, skin cracking and fissure. Hand > feet
Cutaneous candidiasis
- diagnosis
- treatment
- prevention
- KOH test, PCR, blood or tissue culture
- topical antifungal (clotrimazole cream, ketoconazole in interdigital and intertrigo), systemic antifungal
- eliminate risk factors, increase hygiene
Candidiasis of oropharyngeal mucosa
- definition
- etiopathogenesis
- classification (5)
-fungal infection of oropharyngeal mucosa
- C. albicans
- imbalance of local flora –> overgrowth of C.albicans
- oropharyngeal cand. (pseudomembranous candidiasis),
- erythematous cand.,
- chronic hyperplastic cand. (candidal leucoplakia),
- candidal angular cheilitis,
- rhomboid glossitis (papillary atrophy)
Candidiasis of oropharyngeal mucosa
-clinical features
- oropharyngeal cand: multiple, coating, pseudomembranous white plaques. They are easily wiped away and show erythematous mucosa
- erythematous cand: multiple - atrophic erythematous plaques, burning sensation, taste sensation disorder, eruptions are painful
- chronic hyperplastic cand: multiple white plaques, CANNOT be wiped off
- candidal angular cheilitis: sore red splits at each side of mouth
- rhomboid glossitis: symmetrical, well demarcated, erythematous and depapillated lesion, with a smooth and shiny surface
Candidiasis of oropharyngeal mucosa
- risk factors
- diagnosis
- treatment
- prevention
- immunosuppression, extremes of age, diabetes mellitus, smoking, malnutrition, medications
- KOH preparation - you will see pseudohyphae
- topical antifungal - nyastatine, miconazole, amphotericin B
- eliminated risk factors, increase hygiene
Vaginal candidiasis
- definition
- etiopathogenesis
- risk factors
- candidal infection of the vagina
- overgrowth of C. albicans
- pregnancy (high levels of glycogen, estrogen and progesterone), immunodeficiency, antibiotics
Vaginal candidiasis
- diagnostics
- treatment
- prevention
- KOH preparation, vaginal pH
- topical azole, single-dose oral fluconazole
- eliminate risk factors, increase hygiene
