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