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Skin Dr Blue1
WVSOM -- Dr. Blue -- FUNGUS/CANDIDA
| Question | Answer |
|---|---|
| What fungus is Pityriasis versicolor? | malassezia furfur |
| What does Malassezia furfur look like? | depigmentaions/pigmentations at sight of growth |
| Where does Pityriasis versicolor reside in teh skin? | superficial layer |
| Is pitryiasis versicolor inflammatory | no |
| What causes Pitryiasis versicolor? | poor hygiene |
| Is Pitryiasis versicolor a tinea? | no |
| Where does Pitryiasis versicolor infect? | crhonic, mild infection of stratum corneum which results in scaly leasions |
| What kind of yeast is Pitryiasis versicolor? | lipophilic |
| is malassezia furfur normal flora | yes |
| What does malassezia furfur use as nutrition? | sebum for fatty acids adn sweat for moisture. |
| Does malassezia furfur break down keratin | no |
| what fungus looks like spaghetti and meatballs under a microscope? | malassezia furfur |
| What does malassezia furfur look like under a microscope | spaghetti and meatballs |
| What fungus will show up under fluoresce under a wood light? | malassezia furfur |
| What is Cradle Cap? | seborrheic dermatitis |
| What is dandruff | seborrheic dermatitis |
| What can Malassezia furfur cause besides Pitryiasis versicolor | seborrheic dermatitis; cradle cap and dandruff |
| What fungus causes Tinea nigra? | exophilia werneckii |
| What does Exophiala werneckii cause? | Tinea Nigra |
| Where is Exophiala werneckii found? | soil and shower curtains |
| What symptoms are seen with tinea nigra | none |
| What can tinea nigra be mistaken for? | melanoma |
| how does tinea nigra present on teh skin? | brown-black pigmented yeasts |
| Is tinea nigra inflammatory | no |
| What does Exophiala werneckii eat? | keratin |
| What does Piedraia hortae cause? | black piedra |
| What does Trichosporon beigelli cause? | White Piedra |
| What fungus's cause black/white piedra? | Piedraia hortae, trichosporon beigelli |
| What is black/white piedra? | infection of external hair shaft |
| What areas of the world is black/white piegra found? | tropical areas |
| What are the subcutaneous diseases? | black/white piedra; tinea nigra; seborrheic dermatitis; Pitryriasis versicolor |
| What are dermaphytoses? | Tineas |
| Are tineas inflammatory? | yes |
| what do tineas infect? | cutaneous skin |
| What is Tinea corporis? | ringworm of trunk, legs |
| what disease does tricophyton rubrum and mentagrophytes cause? | tinea corporis and pedis |
| What diesase does microsporum cause? | tinea corporis |
| What fungi cause tinea corporis? | trichophyton rubrum; microsprum canis; trichophyton mentagrophytes |
| What is tinea imricata? | concentric rings of scales over trunk, legs and forearms |
| What fungi cause tinea imricata | trichophyton concentricum |
| what disease does trichophyton concentricum cause? | tinea imricata |
| Are tineas comunicable? | yes |
| What causes the inflammatory response with tineas? | metabolization of keratin |
| What is tinea pedis? | athletes foot |
| What kind of pattern does tinea pedis leave? | moccasin pattern |
| What is seen on the foot with Tinea pedis? | lateral side of foot. Itching and skin cracks. |
| What does tinea nigra digest? | mostly dead keratin |
| What is recurrence rate of tinea pedis? | 60-80% |
| What fungi are responsible for tinea pedis? | trichophyton mentagrophytes,Epidermophyton floccsum |
| What is Tinea cruris? | jock itch |
| What fungi cause jock itch | trichophyton rubrum, epidermophyton floccusum and trichophyton mentagrophytes |
| What do men get jock itch | they scratch themselves after having athletes foot |
| what is tinea capitis | scalp ringworm, favus |
| Who gets tinea capitis? | cildren |
| Waht is ectothrix | candidia on outside of hair shaft |
| What is endothrix? | candidia on inside of hair shaft |
| What is tinea capitis confused with? | dandruff |
| How is tinea capitis confused with dandruff? | tinea capitis is inflammatory |
| what fungi cause tinea capitis | trichophyton tonsurans, microsporum audouinii, canis, trichophyton schoenleinii, trichophyton violaceum |
| What is tinea barbae | infection of the hair and skin around the bearded area from uncleaned razors and sharing razors; also from pets because they are soil organisms |
| What fungi are responsible for tinea barbae? | Trichophyton verrucousm, T. mentagrophytes |
| What is Tinea unguium? | onychomycosis of the nails |
| What fungi are responsible for tinea unguium? | Tricophyton rubrum, T. mentagrophytes, Furasuium sp. candida sp. |
| How does Tinea unguium occur? | thru cuts, digging thru dirt, soaking in lots of water |
| What kind of infection is chromoblastomycosis? | subcutaneous fungal infection; presents as wart-like, cauliflower, pigmented lesions |
| What fungal infection looks like "copper penny spores" under microscopy? | Chromoblastomycosis |
| What fungi are responsible for Chromobastomycosis? | Fonsecaea, cladosporium, Pilaophora sp. |
| where is chromoblastomycosis seen? | usually of the foot or hands |
| what does chromoblastomycosis feed on? | organic matter over keratin (dead organic) |
| What form is chromoblastomycosis in when present in subcutaneous layer? | yeast |
| What kind of people get chromoblastomycosis? | barefooted workers experiencing trauma. Takes a lot of force to get it there. |
| How long does chromoblastomycosis take to develop? | months to YEARS |
| How id chromoblastomycosis treated? | surgery and itrconazole |
| What is Sporotrichosis? | Rose thorn Disease; |
| What do "asteroid bodies" seen in microscopy respresnt? | Sporotrichosis |
| What fungus is associated with sporotricosis? | sporothrix schenckii |
| Where does sporothrix schenckii grow? | bark and thorns of rose bushes |
| What does Sporothrix schenckii look likeunder the microscope? | asteroid body |
| What kind of patients present with sporotrichosis? | opptorunistic with AIDS |
| what is the clincial presentation of sprorotrichosis? | nodular granulomas and with ulcerative papules that spread via draining in the lymph channels |
| What is Fungal mycetoma? | madura foot |
| What is the clincial presentation of madura foot? | initially small painless papules and nodules; leads to bone and tissue destruction |
| What is the pathogenesis of fungal mycetoma? | grows quicker than other fungi. sinus tract formation leads to spread. Deeper tissue infiltration leads to bone destruction of a period of months/years |
| What organism is responsible for fungal myecetoma | Madurella |
| How is fungal mycetoma gven to the host? | infection is via thorns and splinters; seen in tropical areas |
| Waht happens if fungal mycetoma is nto treated quickly? | amputation |
| When is spaghetti and meatballs seen? | malasezzia under a microscope after KOH digestion of skin scraping |
| When are Ids seen/ | often accompany cutaneous fungal ifnections. |
| What are Ids? | papules that conatin no fungal infection but arise in distal areas due to cutaneous infections |
| What are copper penny spores? | yeast form of fungus seen in microscopy in chromoblaqstomycosis. Not really spores |
| what is most common candida | Candida albicans |
| What is candida albicans | normal flora that everyone has in gi tract and some have in skin and mucous membranes |
| What is candida tropicalis? | true commensalist. does nto cause a problem unless the environment it lives in is disrutped allowing it to grwo and cause disease |
| How is candida aquired? | water, soil, food, animals adn people |
| What is candida parapsilosis? | commensalist. only becomes a problem when environment is disrupted to allow overgrowth |
| Where is candida tropicalis seen? | under teh skin, GI tract adn mucus membranes |
| Where is candida parapsilosis seen in humans? | sking, Gi tract adn mucus membranes |
| What is candida glabrata | commensalist; resistant to antifungal treatments; not a problem unless environment allows overgrowth |
| What is candida krsei? | commensalist; not aproblem unless overgrowth occurs; resistent to some antifungals |
| Which candida are drug resistant? | C. glabrata, C guilliermondii; c. drusei |
| What is candida dubliniensis? | true pathogen; primarily in african adn surrounding nations |
| What is most common sites of candida infections? | oral, penial, vaginal |
| Where are most cutaneous candida infections seen? | skin folds |
| What is folliculits? | associated with hair |
| what is balantitis? | penile infection usually associated with skin around the glans and the skin underneathwhere it is moist |
| what is intertrigo? | skin fold appearance of infection. combined infection of candida and commensual bacteria |
| what is most common cause of diaper rash? | candida |
| how does candida cause diper rash? | part of normal gi tract flora so present in feces |
| When do you have systemic candida disease? | under debilitating disease or immunodeficient disease |
| Where do systemic candida infections originate? | GI tract; also main cause of death |
| What is candidemia? | hematogenous spread to any organ of candida |
| what is seen in CNS candida infection? | meningitis; encephalitis; brain abscesses |
| what is seen in respiratory candida infection | pneumonia |
| what is seen in CV candida infection? | seeding of the heart valevs; endocarditis; pericarditis; myocarditis |
| what is seen in ABD candida infection? | peritonitis affecting liver, spleen, gallbadder, pancreas |
| When is abdominal candida infection usually seen? | ABD surgery |
| what What is seen with candida infection of the bladder? | UTI |
| What is main cause of candida UTIs? | urinary catheterizaion |
| what is acute pseudomembranous candidiasis? | oral thrush |
| what is vulvovaginal candidiasis? | yeast vaginitis. most common |
| how does candida infect the esophagus? | esophagitis is caused by being spread down the mouth to the esophagus |
| when does gastrointestinal candidiasis seen? | high powered antibiotics wipe outnormal flora of the GI and candida takes over |
| When is candida considered the #1 cause of infection? | Immunodeficiency; DM; cancers; long term corticosteroids; neutropenia; long term antibiotics; prolonged hospital stay; alterasions in GI mucosa |
| why does cancer help promote candida infection? | immunodeficiency that the cancer chemotherapeutic agents induce |
| why are diabetics prone to candida? | usually dysfunction of the neutrophils and prone to the opportunistic infections from their own candida albicans as well as candida from outside |
| How is a gram stain used to differentiate between yeast and bacterial disease | 100x bigger than bacteria. used freaquently on skin sites; if yeast greater than bacterial count then yeast is cause of disease |
| Explain KOH | gets rid of tissue in order to see the yeast better. psuedohyphae can still be seen. |
| In a differential diagnosis of candida on an agar plate what colors are represented? | blue -- tropicalis; white -- parapsilosis; -- green -- albicans |
| What do green streaks on an agar plate represent? | C. albicans |
| Waht does a blue streak on an agar plate represent? | C. tropicalis |
| What does a white streak on agar represent? | C. parapsilosis |
| What are the pathogenic factors of Candida? | adherence; proteinases; phospholipases; phenotypic switching |
| How is adherence important with Candida? | stronger the adherence, the more virulent it is; Candida can adhere to medical devices adn contact lenses |
| what causes color differentiation in differential agar? | carbohydrate utilization |
| How can Candida be diagnosed? | agar, gram stain, blood culture, germ tube test, species-specific enzymem tests, carbohydrate utilization tests, antigen, antibody dectction, PCR, anti-fungal susceptibility tests |
| How is germ tube test used to diagnose? | drop it in serum (rabbit most common); candida in serum will put out fibriles; |
| how is carbohydrate utilization test used to diagnose Candida? | single carbohydrate utilization tests for strains other than the five most common |
| What is the problem with antigen, antibody detection tests? | part of normal flora therefore the presence of Candida antibody really doesn't mean much |
| when are virulence factors true for candida? | only when there are opptorunistic conditions |
| is formation of pseudohyphae dimorphism? | no |
| what is pseudohyphae? | elongation of the coccal form of the yeast... buds do not separate |
| can hyphae change over in candida... | yes but it is very rare |
| what do proteinases and phopholipases do for virulence | help break down lipids to give Candida invasive quality |
| What does Phenotypic switching allow for in Candida? | ability to alter nutrient sources; form pseudohyphae;survive neutrophil killing; antifungal resistance |
| Explain antifungal resistance | genes turn off and on in phenotypic switching to resist -AZOLE drugs. Only certain species |
| What is oral thrush? | acute pseudomembranous candidosis |
| where is oral thrush usually seen? | infants and elderly 2nd |
| why does oral thrush happen? | infants don't have a fully functional immune system yet |
| How do infants acquire candida? | can be exposed in vaginal canal but is usually oral acquistion... they are not born with it; may be received thru breast feeding |
| How can oral thrush be passed to a neonate | thru vaginal canal of the mother; then with breast feeding can keep getting reinfected; if infant has thrush, mother's nipple should be examined for candida |
| What shoudl be considered if an adult or adolescent gets oral thrush? | immunodeficiecy or metabolic problem; check for DM and immunodeficienicy; may be first sign of HIV |
| where will oral thrush be seen? | tongue, buccal-mucous membranes |
| what dos thrush look like? | cottage cheese patches |
| where does thrush appear in geriatrics? | dentures due to lack of hygeine; allows candida to grow around the surface of teh gums and on palate in back of mouth |
| what is treatment for oral thrush | nystatins, -AZOLE drugs 2nd line |
| is a swabbing showing candida in vaginal swab diagnostic for vaginal thrush? | NO, it is normal flora |
| how is Candida passed in yeast infections? | normal flora of vagina and occasionally from fecal transmision or sexually from a partner |
| what is a key to causing vaginal thrush? | pH of vagina |
| what is normal pH of vagina? | 4.5 |
| what environment in the vagina allows overgrowth? | down to 4.0 or lower |
| what environment in vagina allows for bacterial growth? | to 7 or higher (alkaline) |
| how is Candida passed to a male sexually? | Balantis (glans) |
| what are are predispositions for vaginitis? | diabetes adn constant oral contraceptive use |
| how does DM cause vaginal thrush? | changes the bacterial flora which will ead to change in pH thus causeing crhonic flora overgrowth |
| how does constant oral contraceptive use cause vaginal thrush? | will change the bacterial flora compenent leading to a change in pH |
| what is the odor of candida? | distince yeast |
| what is color and consistency of candida infection? | cury adn lumpy; white |
| what clinical features are assoicaated with vaginal thrush and bacteria? | fishy; abundant discharge that is frothy, grey and white |
| what clincial features are seen with trichomonas vaginal thrush? | foul odor; frothy discharge that is greeish-yellow |
| what is vaginal ining in fungal thrush? | dry, red |
| what is vaginal lining in bacterial thrush? | pink |
| what is vaginal lining with trichomonas? | tender, red |
| what is easies way to differentiate the vaginal thrush? | gram stain; diffentiate between causitive agent; predominant organism is the cause |
| do gram positive rods indicate bacterial vaginal thrush? | NO! lactobacillus is normal flora |
| what do gram negative rods in vaginal thrush indicate? | gardnerella |
| what is treatment for vaginal thrush? | diflucan (-AZOLE drugs) |
| when do you use nystatin in vaginal thrush? | if resistant to -AZOLE |
| where is cutaneous candidiasis seen? | skin and nails |
| can Candida peentrate intact skin? | no |
| where is cutaneous candida seen? | on surface of skin |
| What is diaper rash 75% of the tiem? | candida |
| what usually causes diaper rash? | child sitting ina wet soiled diaper for an extended period of time |
| why does fecal matter allow growth of candida? | it is very acidic |
| wht rash is seen with diaper rash? | pruritic rash; vesicular to pustular |
| waht os onychomycosis? | nail bed infection with fungus |
| what is paronychia? | fungral growth of the nail bed |
| what conditions make you susceptible to candida nail bed infection? | hands in water constantly; glvoed canstantly with moist conditions |
Created by:
tjamrose
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