Oropharyngeal and Esophageal Candidiasis - Fungal Infection Flashcards
(T/F) - Oropharyngeal candidiasis (OPC) and esophageal candidiasis (EC) are the most common opportunistic infection in HIV
TRUE
OPC and EC are mostly seen in what population?
- Children
- Immunosuppressed
What is the most common fungal organism that can cause OPC and EC?
C. albicans
(T/F) - Candida is usually pathogenic in immune competent host
FALSE - not usually pathogenic
(T/F) - Loss of T-lymphocyte mediated immunity or neutropenia can let Candida convert to pathogenic hyphal phase
TRUE
What factors can cause a risk of OPC and EC to occur?
- Drugs
- Diseases
- Age
- Nutritional
- Others
What drugs will be included as risk factors?
- Immunosuppressants
- Anticholinergics
- Corticosteroids
What diseases will be included as risk factors?
- HIV
- DM
- Leukemias
- Other malignancies
- Trauma
- Burns
- Xerostomia
What ages will be included as risk factors?
- Neonates OR
- Advanced age
What nutrition will be included as risk factors?
- Vitamin A and B
- Iron
- Folate
What other risk factors can be included?
- Dentures
- Radiation
- ETT
- Smoking
What signs occur with OPC?
- Erythema
- White patches of buccal mucosa, tongue, throat, or gums
- No constitutional signs
What Sx occur with OPC?
- Asymptomatic
- Mouth pain
- Burning tongue
- Metallic taste
What signs occur with EC?
- Plaques may be edematous with ulceration in severe cases
- Few to numerous white to beige plaques
- Constitutional signs occasionally occur
What Sx occur with EC?
- Dysphagia
- Odynophagia
- Retrosternal chest pain
How would OPC be treated in a mild condition?
- Clotrimazole troches 10 mg given 5x/day for 7-14 days
- Miconazole mucoadhesive buccal 50 mg tabs to upper gum QD for 7-14 days
How would OPC be treated in a moderate-severe condition?
Fluconazole 100-200 mg QD for 7-14 days
How would EC be treated if the patient can be given PO products?
Fluconazole 200-400 mg PO QD
How would EC be treated if the patient cannot be given PO products?
- Fluconazole 400 mg IV QD for 14-21 days OR
- Echinocandins for 14-21 days
Is prophylaxis recommended in patients for OPC and EC?
Generally, not recommended
If a patient is recommended for prophylaxis for OPC or EC, which medication(s) are usable?
Fluconazole only
