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Flashcards in AIDS and Headache Deck (12):

Fungal classification: Yeasts and moulds examples, very simple classification

Yeasts: Candida albicans and other candida. Crytptococcus neformans

Moulds: dermatophytes, aspergillus species


Candida albicans features

-commensal in mouth, gut and vagina
- overgrowth occurs when antibacterial therapy, hormone level changes, immunosuppresion

Causes: thrush (oral/vaginal); cutaneous/nail candidiasis; urinary catheter bladder relate; rare systemic


Candidiasis treatment

Usually topical, sometimes oral
Nystatin suspension or pastilles; amphotericin B pastilles; azole pessaries or cream


Cryptococcus neoformans features

-Environmental (pigeon faeces, eucalyptus trees
-Pulmonary infection due to inhalation
-Spreads to CSF via blood in immunodeficiency
-Meningitis in people with AIDS (corticosteroids therapy long term)
-Chronic lymphocytic meningitis: slow deterioration, head ache and fever


C. neoformans diagnosis

-10-100 WBC's in CSF. Not PMN predominance. High protein, low glucose
-antigen + in CSF and serum
-india ink stain


Cryptococcus meningitis treatment

IV amphotericin
IV or oral fluconazole
6 weeks therapy


Dermatophytes and what they cause

Tinea: ringworm =capitis, corporis, cruris, pedis (athletes foot). Never invasive

sourced from animals and humans


Common dermatophytes

trichophtyon rubrum >70%
" mentagrophytes 20%
Microsporum canis 5%
Epidermophyton floccosum 3%


Dermatophyte treatment

SKIN: topical azole (clotrimazole, econazole, ketoconazole, micoanzole)
Nails: oral agent- terbinafine or itraconazle


Other common skin fungal infections

Pityriasis versicolor: Malassezia furfur. Hyperpigmented macules on trunk, depigmenting rash. 2 week topical or 1 week oral azole

Seborrheic dermatitis: pityrosporum species. Greasy facial rash, dandruff. Topical azole


Rare mould disease and features

Aspergillus fumigatus

-rare cause of severe disease in neutropenic patient
-amphotericin to treat


Anti-fungal drugs

Amphotericin B: binds to ergosterol, disrupts cytoplasmic membrane. Can cause anaphylaxis. IV
Azoles: inhibit ergosterol synthesis