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CP > Fungal Pathogens > Flashcards

Fungal Pathogens Flashcards

1
Q

What are fungi?

A 
Kingdom
Eukaryotic
Single or multi-celled
Mainly hyphal or yeast formations
Glucan-chitin wall
Asexual and/or sexual reproduction
Saprophytic
Plant pathogens and very rarely animal pathogens
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2
Q

Types of fungal disease

A

Superficial
Subcutaneous
Systemic

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3
Q

Superficial infection

A

Affects skin, hair, nails and mucocutaneous tissue

Dermatophytes, Malassezia, Candida

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4
Q

Subcutaneous infection

A

Subcutaneous tissue affected, usually following traumatic implantation

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5
Q

Systemic infection

A

Affects organs

Candida and Aspergillus

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6
Q

Dermatophytes

A

Slow growing moulds causing superficial infection

Originate in soil, other animals or humans

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7
Q

Tinea pedis

A 
Athlete's foot
Uni or bilateral
Itching, flaking, fissuring of skin
Typical cause Trichophyton rubrum
Mainly in adults
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8
Q

Tinea ungulum

A

Fungal nail disease
Also called onychomycosis
Four main types
Trichophyton rubrum and T. interdigitale

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9
Q

Tinea cruris

A

Jock itch (groin area)
More prevalent in men
Itching, scaling, erythematous plaques with distinct edges
May extent to buttocks, back and lower abdo
T. rubrum

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10
Q

Tinea corporis

A

Ringworm

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11
Q

Tinea capitis

A

Scalp ringworm
Mainly in pre-pubescent children
Ranges from slight inflammation, to scaly patches, alopecia, black dots, grey patches, to severe inflammation

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12
Q

Tinea barbae

A

Face skin (shaved)

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13
Q

Kerion celsi

A

Boggy, inflamed lesion within tine capitis, usually from zoophilic dermatophytes

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14
Q

Investigation for treatment of dermatophyte infection

A

Microscopy and culture

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15
Q

Treatment of mild disease

A

Topical antifungals (terbinafine, clotrimazole)

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16
Q

Treatment of severe disease

A

Systemic antifungals

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17
Q

Treatment of any tinea capitis

A 
Systemic antifungals (griseofulvin, terbinafine, itraconazole)
Topical will not be curative (role in reducing spread)
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18
Q

Malassezia

A

Genus of yeasts
Part of normal skin flora
Most frequent on head and trunk

19
Q

Pityriasis versicolor

A 
Hyper or hypo-pigmented lesions
Upper trunk
Puberty - middle age
More common in tropics
Tends to relapse
20
Q

Diagnosis of pityriasis versicolor

A

Microscopy - culture difficult and not interpretable

21
Q

Treatment of pityriasis versicolor

A

Topical antifungals, if that fails then oral

22
Q

Candida

A

Large genus of yeasts
Causes thrush (oral and vaginal) and also occasionally skin disease and keratitis
Can affect almost any organ

23
Q

Acute-pseudomembranous superficial candida infection of the oral mucosa

A

Classical oral thrush
Low CD4 count
Younger patients
Asthma with steroid inhalers

24
Q

Chronic atrophic superficial candida infection of the oral mucosa

A

Older patients

Erythema

25
Q

Candida vulvovaginitis

A

Vaginal thrush
Affects 70-80% of women at least once during child-bearing years
Pruritis, burning sensation, possible discharge
Inflammation
Often worse during pregnancy
Approx. 10% will have recurrent infections
Diagnosis by +ve culture

26
Q

Treatment of candida

A

Usually oral azoles, though resistance can be an issue

27
Q

Azoles in pregnant women

A

Only use topical as oral azoles can be a teratogen

28
Q

Systemic candidosis

A

Defined by site

Usually from colonised skin, mucosal sites or GI

29
Q

Candida oesophagitis

A

Mainly in HIV
Pain/difficulty on swallowing
Diagnosed with endoscopy with biopsy

30
Q

Candidaemia

A

Candida in blood culture
Remove lines where possible
Start antifungal therapy
Check eyes and heart

31
Q

Ocular candidosis

A

3-25% following candidaemia

Mainly candida chorioretinitis and secondarily candida endophthalmitis (which requires intravitreal antifungals)

32
Q

Candida endocarditis

A

2-3% following candidaemia
IV drug abusers, valve surgery
Vegetations seen on heart valves - normally need valve replacements
Fever, weight loss, fatigue, heart murmur

33
Q

Renal candidosis

A

Candida infecting kidney from blood

Immunocompromised premature neonates

34
Q

Urinary tract candida

A

Common to have candida but does not necessarily mean UTI

Difficult to treat as most antifungals not excreted in urine

35
Q

Candida peritonitis

A

Peritoneal dialysis complication
Bowl perforation
Treatment by source control/drainage and antifungals

36
Q

Diagnosis of systemic candidosis

A

Culture, ideally from sterile site, blood, peritoneal fluid etc
Imaging

37
Q

Treatment of systemic candidosis

A

Depends on sensitivity, severity, need for oral agent
Echocandins (IV)
Azoles (oral)
Liposomal amphotericin B (IV)

38
Q

Bullseye sign

A

Bullseye appearance of cysts on spleen

39
Q

Aspergillus

A

Genus of moulds
Produces airborne spores
Universal exposure
Airways may be colonised

40
Q

Reactions to aspergillus inhalation

A

If healthy: nothing
Cavities from other conditions: fungal ball
Asthma, CF: Allergic bronchopulmonary aspergillosis, allergic sinus disease
Chronic lung disease: Chronic pulmonary aspergillosis
Immunocompromised: Invasive pulmonary aspergillosis, invasive aspergillus sinusitis

41
Q

Aspergilloma

A

Solid balls of fungus

Often indolent but may break up causing haemoptysis which can be fatal

42
Q

Halo and air crescent sign

A

CT scan signs

Associated with invasive aspergillosis

43
Q

Aspergillosis diagnosis

A

Culture
Serology
Imaging

44
Q

Aspergillosis treatment

A

Aspergilloma, resection
Allergic aspergillosis, steroids +/- antifungals
CPA and invasive aspergillosis, antifungals

CP (19 decks)

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