Section 26- Fungal Infections Flashcards
KOH preparation in Candida
Pseudohyphae and yeast forms
Topical treatment for cutaneous candidiasis
Nystatin
Azole
Imidazole cream or powder
May be effective in recurrent cutaneous candidiasis
Eradicates bowel colonization
Nystatin suspension or tablet
AIDS defining classification of mucosal candidiasis
Esophageal and Tracheobronchial
Portal of entry of Candida in disseminated disease
GI tract
Treatment for oropharyngeal candidiasis
Topical- nystatin or cotrimazole
Systemic- fluconazole and echinocandins (caspofungin, micafungin)
Genital candidiasis treatment
Azole creams or suppository
Onset of chronic mucocutaneous candidiasis
Infancy or early childhood
Common cause of nosocomial infections
Risk factors: neutropenia, venous access catheters
Small disseminated erythematous cutaneous papules
Disseminated candidiasis
Treatment for disseminated candidiasis
Echinocandins
Fluconazole
Amphotericin B
Lipophilic yeast that normally resides in keratin of skin and hair follicles
Malassezia furfur
M. globosa
Well demarcated patches with fine scale
Hypo/hyperpigmented
Most common in trunk
Predisposing factors: sweating and oily skin
Tinea versicolor
Malassezia furfur result on KOH preparation
Spaghetti and meatballs
Round yeast and elongated pseudohyphae
Woods lamp fluorescence in pityriasis versicolor
Blue green
Topical treatment for pityriasis versicolor
Selenium sulfide 2.5% lotion or shampoo
Ketoconazole shampoo
Azole creams
Terbinafine 1% solution
Systemic therapry for pityriasis versicolor
Fluconazole 300mg once a week x 3 weekd
Itroconazole 400ng single dose
What differentiates malassezia folliculitis from acne vulgaris?
Absence of comedones
Asymptomatic superficial fungal colonization of the hair shaft
Piedra
White to beige nodules on hair shaft
Soft, easily removed
White piedra
Darkly pigmented, firmly attached nodules on hair shaft
Weakens hair shaft with hair breakage
Affects scalp hair
Black piedra
Treatment for trichosporon infections
Topical or systemic azoles
Amphotericin B
Superficial fungal colonization of the stratum corneum
Tinea nigra
Fungus associated with tinea nigra
Hortaea werneckii
More common in tropical climates
Direct inoculation onto skin from contact with decaying vegetation, wood or soil
Brown to black macules with well defined borders that resemble silver nitrate stains
Tinea nigra
Treatment for tinea nigra
Topical azole
Alochol gel sanitizer
Most common cause of epidermal dermatophytosis and onychomycosis in industrialized nations
Trichophyton rubrum
KOH preparation:
Multiple septated tubelike structures (hyphae or mycelia)
Dermatophytes
Woods lamp fluorescence for Microsporum spp
Blue green
Most common dermatophytic infection
Epidermal dermatophytoses
Most effective oral antidermatophyte antifugal
Terbinafine 250mg tablet
-allylamine
This systemic antifungal used in dermatophytoses needs acidic gastric pH for dissolution of capsule
Itraconazole
Most common site of tinea pedis
Between 4th and 5th toes
Condition that may coexist with interdigital tinea pedis
Erythrasma
Topical agents for epidermal dermatophytoses
Imidazoles (clotrimazole, miconazole, ketoconazole)
Allylamines (terbinafine)
Naphthiaonates (tolnaftate)
Substituted pyridine ( ciclopirox olamine)
Treatment for tinea manuum
Or dermatophytoses of hands feet and nails
Oral agents:
Terbinafine 250mg OD X 14 days
Itraconazole 200mg OD x 7 days
Fluconazole 150-200mg OD for 2-4 weeks
Epidermal dermatophytosis that occurs after topical application of a glucocorticoid preparation to a site colonized or infected by dermatophyte
Tinea incognito
Type of dermatophytic folliculitis where mycelia and arthroconidia are seen on the surface of the hair follicle
Ectothrix type (extrapilary)
Type of dermatophytic folliculitis where mycelia and arthroconidia are seen within the hair shaft
Endothrix type (intrapilary)
Variant of endothrix resembling seborrheic dermatitis
Black dot tinea capitis
Variant of endothrix with arthroconidia and airspaces within hair shaft
Favus
Boggy purulent inflamed nodules and plaques Usually painful Drains pus from multiple openings Hairs do not break off but fall out Heals with scarring alopecia
Kerion
Latin for honeycomb
Perifollicular erythema and matting of hair
Later thick yellow crusts (scutula) composed of skin debris and hyphae
Fetid odor
Favus
Dermatophytic folliculitis with foreign body granuloma in response to keratin in dermis and immune reaction to dermatophyte
Occurs with immunosuppression
Distribution: any hair bearing area
Majocchi granuloma
Treatment for Sporotrichosis
Itraconazole
Caused by Madurella species
Swelling, development of sinus tracts and fistula
Unilateral on leg foot and hand
Cauliflower like tumors
Eumycetoma
Most common invasive mycosis in HIV disease
Primary pulmonary infection
Papules or nodules with surrounding erythema, may exude mucinous fluid
Molluscum contagosum like, acneiform
Cryptococcosis
Primary prophylaxis for cryptococcosis in HIV patients
Fluconazole
Therapy for cryptococcal meningitis
Amphotericin B
