oral candidal infections Flashcards
pseudomembranous candidiasis
white patches that can be scraped off
associated with immunocompromised, antibiotic use or poorly controlled diabetes
N.B aspiration pneumonia
local tx for pseudomembranous candidiasis
if using steroid inhaler, rinse after use/consider use of spacer
erythetamous candidiasis
red patches on oral mucosa> dorsal surface of tongue
manifests as depapillated areas
e.g. denture induced stomatitis
local tx for erythetamous candidiasis
denture hygiene: brush palate, soak dentures in chlorhexidine/ milton
if using inhaler, rinse after use, use spacer
hyperplastic candidiasis
POTENTIALLY MALIGNANT REFER
white patches that cannot be wiped off diagnosis only by biopsy and histopathological analysis
associated with haematinic deficiencies, smokers
angular chelitis
caused by c albicans and s aureus
associated with reduced ovd> dentures, haematinic deficiencies and diabetes
drug tx for angular chelitis
miconazole effective against both candida and gram-positive cocci, first line
if clearly bacterial- sodium fusidate
drug tx for candidal infections
fluconazole
50mg 1x daily 7 days
max 14
miconazole oromucosal gel 20mg/g
pea sized amount after food 4xdaily
continue use for 7 days after lesions have healed
Warfarin/statins contraindication
drug tx if pt on warfarin/ statins
nystatin oral suspension
1ml after food 4x daily 7 days
rinse and retain near lesion for 5 mins before swallowing
use for 48 hours after lesions have healed
mechanism of action of fluconazole and nystatin
azoles
act by inhibiting protein synthesis pathway (ergosterol) FUNGALSTATIC
polyenes (nystatin)
act directly by boinding to ergosterol, create pores, leakage of contents, cell lysis FUNGALCIDAL
azole resistance
c krusei and c glabatra are naturally resistant to fluconazole, some c albicans have developed resistance
query sensitivity test for subtyping
