Fungal Disease Flashcards
(105 cards)
1
Q
What are the most common systemic mycoses in neutropaenic patients?
A
Candidiasis
Aspergillosis
2
Q
HIV, is ass. with which systemic mycoses?
A
Histoplasmosis
Coccidiomycosis
Cryptococcosis
Talaromycosis
3
Q
The following image demonstrates the microscopic appearance of which organism?
A
Candida species
4
Q
Describe the common cutaneous presentation of systemic candidiasis
A
Firm erythematous papules and nodules
- often with a pale center (although can be haemorrhagic)
Ecthyma gangrenosum like lesions
5
Q
Which organisms can cause systemic candidiasis?
A
Candida Albicans
Candida Tropicalis (frequent cut. lesions)
Candida Glabrata
Candida Krusei
6
Q
What are the cutaneous features of aspergilosis?
A
Nectrotic papulonodules
Subcut nodules
7
Q
What are the organisms that cause aspergillosis?
A
Aspergillus flavus and fumigatus
8
Q
Which organism is depicted below?
A
Aspergilus
9
Q
What are the cutaneous features of mucormycoses?
A
Ecthyma gangrenosum like lesions
Cellulitis
Facial edema
Necrotic papulonodules
Plaques
Large haemorrhagic crusts of the face
10
Q
What organisms cause mucormycosis?
A
Mucor
Rhizppus
Lichthemeimia
11
Q
What are the cutaneous features of crytococcosis?
A
Ulceration
Cellulitis
Molluscum contagiosum like lesions
12
Q
How is aspergillosus contracted?
A
Primary - inhaled
Secondary - direct port of entry through compromised skin barrier
13
Q
Aspergillosis and mucormycosis are angioinvasive.
A
True
14
Q
Where is Cryptococcus neoformans found?
A
Pigeon droppings
15
Q
A
Septal hyphae
= Aspergillosus
16
Q
A
Ribbon like - non, septal hyphae
=Rhizopus (mucormycosis)
17
Q
A
Dermal yeasts with gelatinous capsules = cryptococcus
18
Q
What is the mortality of diseminated candidiasis?
A
20 - 60%
19
Q
What organism causes histoplasmosis?
A
Histoplasma Capsulatum
20
Q
Where is Histoplasma found?
A
soil - moist climates
21
Q
A
intracellular yeast forms surrounded by a rim of clearing
Histiocytes and giant cells are the host cells in histoplasmosis
22
Q
A
23
Q
How is histoplasmosis treated?
A
Amphotericin B IV up to 1mg/kg/day
second line: itraconazole
24
Q
List the common Trichophyton Spp
A
Tonsurans
Rubrum
Mentagrophytes
Interdigitale
Indotineae
Violaceum
Verrucosum
25
What are the classes of dermatophytes?
Microsporum,
Epidermophyton,
Trichophyton
## Footnote
Dermatophytes are a group of fungi that cause skin infections.
26
How are dermatophytes spread?
Anthropophilic (Human - Human)
Zoophilic (Animal -Human)
Geographic (Soil - Human)
## Footnote
These modes of transmission indicate the source of infection.
27
What is anthropophilic spread?
Human to human with chronic mild inflammatory response
## Footnote
This type of spread is common among certain dermatophytes.
28
What is zoophilic spread?
Animals to human with massive inflammatory response in humans
## Footnote
This type of spread often leads to severe symptoms.
29
What is geographic spread?
Soil to humans with severe inflammatory response & scarring
## Footnote
This type of spread is less common and involves specific species.
30
Which organisms exhibit anthropophilic spread?
All Trichophyton spp except T mentagrophytes and T verrucosum, E floccosum, M audouinii, M ferrugineum
## Footnote
These organisms primarily spread between humans.
31
Which organisms exhibit zoophilic spread?
M canis,
M nanum,
T verrucosum,
T mentagrophytes
## Footnote
These organisms are typically transmitted from animals to humans.
32
Which species shows geographic spread?
M. gypseum
## Footnote
This species is unique in its transmission from soil.
33
Common organisms that cause tinea capitis and are they endothrix or ectothrix?
Trichophyton tonsurans - Endothrix, Microsporum canis - Ectothrix, Trichophyton violaceum - Endothrix
## Footnote
Tinea capitis is a fungal infection of the scalp.
34
Most common cause of tinea corporis?
Trichophyton rubrum, Trichophyton mentagrophytes
## Footnote
Tinea corporis is also known as ringworm.
35
Most common cause of tinea facei?
Trichophyton rubrum, Trichophyton mentagrophytes, M canis
## Footnote
Tinea facei affects the face.
36
Most common cause of tinea pedis?
Trichophyton rubrum, Epidermophyton floccosum, Trichophyton interdigitale, Trichophyton mentagrophytes (Bullous)
## Footnote
Tinea pedis is commonly known as athlete's foot.
37
Most common cause of onychomycosis?
Trichophyton rubrum, Trichophyton interdigitale, Epidermophyton floccosum
## Footnote
Onychomycosis is a fungal infection of the nails.
38
What are the four subtypes of tinea pedis?
Moccasin, Interdigital, Inflammatory, Ulcerative
## Footnote
Each subtype presents with different symptoms.
39
How would you treat tinea corporis?
1st line: Topical Terbinafine cream BD for 4 - 6 weeks, 2nd line: Topical Clotrimazole cream BD for 4 - 6 weeks
## Footnote
Systemic treatment is reserved for more severe cases.
40
How would you treat tinea capitis?
1st Line: Oral Terbinafine (weight-based dose), 2nd Line: Oral Griseofulvin 20mg/kg/day, 3rd Line: Oral Itraconazole 5mg/kg, Adjuncts: Ketoconazole shampoo
## Footnote
Systemic therapy is often necessary due to scarring risks.
41
How would you treat onychomycosis?
1st Line: Oral Terbinafine, 2nd Line: Oral Fluconazole, 3rd Line: Oral Itraconazole, 4th Line: Oral Griseofulvin
## Footnote
Topical therapy is generally ineffective for onychomycosis.
42
What is Tinea capitis?
A fungal infection of the scalp caused by Trichophyton tonsurans, Microsporum canis, and T. violaceum.
43
What is Ectothrix?
A type of tinea capitis characterized by black dot and arthroconidia within the hair shaft.
## Footnote
Organisms include T. rubrum, T. tonsurans, T. yaunde, T. schoenleinii, T. violaceum, T. gourvilli, and T. soudanense.
44
What is Endothrix?
A type of tinea capitis characterized by arthrospores around the hair shaft.
## Footnote
Fluorescent under Wood's lamp. Organisms include M. canis, M. audouinii, M. gypseum, M. ferrugineum, M. distortum, and T. schoenleinii.
45
What is Favus (tinea favosa)?
The most severe form of tinea capitis, causing honeycomb destruction of the hair shaft by T. schoenleinii with yellow cup-shaped crusts (scutula).
46
What is Kerion?
An abscess caused by a fungal infection.
## Footnote
Organisms include M. canis, T. verrucosum, T. mentagrophytes, and T. tonsurans.
47
What is Majocchi granuloma?
A deep and persistent suppurative and granulomatous folliculitis caused by a fungal infection.
## Footnote
Organism: T. rubrum.
48
What is Tinea corporis?
A superficial fungal infection characterized by a ring-shaped lesion.
## Footnote
Organisms include T. rubrum and T. mentagrophytes.
49
What is Tinea imbricata?
A superficial fungal infection generally caused by T. concentricum.
50
What is Tinea barbae?
A fungal infection of the beard and moustache region.
## Footnote
Organisms include T. verrucosum (cattle), T. mentagrophytes, M. canis, and T. tonsurans.
51
What is Tinea faciei?
A fungal infection of the face, usually caused by zoophilic species.
## Footnote
Organisms include M. canis, T. mentagrophytes, and T. rubrum.
52
What is Tinea cruris?
A fungal infection of the inner thigh.
## Footnote
Organisms include T. rubrum, E. floccosum, and T. interdigitale.
53
What is Tinea pedis?
A fungal infection of the feet.
## Footnote
Organisms include T. rubrum, E. floccosum, and T. interdigitale. Bullous type caused by T. mentagrophytes.
54
What is Tinea manuum?
An infection of the palm and interdigital spaces.
## Footnote
Organisms include T. rubrum, T. mentagrophytes, and E. floccosum. Often presents as non-inflammatory and unilateral 'two feet one hand syndrome'.
55
What is Onychomycosis?
A fungal infection of the nails.
## Footnote
Distal type caused by T. rubrum, T. interdigitale, and E. floccosum; proximal type by T. rubrum (increased risk of HIV); dark onychomycosis by Scytalidium spp; white superficial onychomycosis by Fusarium spp & Scopulariopsis brevicaulis.
56
What are the causes of nodules on the hair shaft?
Black Piedra
Whire Piedra
Nits
Trichomycosis
Tirchorrhexis nodosa
Hair cast
57
Describe DDx
Single, sharply demarcated brown macule on the finger
Dx: Tinea Nigra
DDx: Cafe au lait macule
58
Describe and DDx?
Hyperpigmented macules and patches with fine scale on the trunk
Dx: Pit Versicolour
59
59
Malassezia appearance on microscopy?
Spagetti and meatballs
60
Yeast and short hyphal forms in the stratum corneum highlighted by a PAS stain
61
White piedra - arthocondidia and blastoconidia
62
Describe
63
What are the three patterns of hair invasion by dermatophytes?
64
What infectious agents might cause sporotrchoid spread?
65
Sporothrix are dimorphic fungi - whether a hyphae or yeast forms depends on the temperature
T
66
What is the difference between a hyphae and a yeast?
Yeasts are microscopic fungi consisting of solitary cells that reproduce by budding.
Molds, in contrast, occur in long filaments known as hyphae, which grow by apical extension
67
Sporothrix cultures rapidly at 25 degrees
T
68
What is the key ddx for sporotrichoid spread?
Sporothrix spp (inc schenckii)
Mycobacterium marinum
69
Topical treatment is often effective for sporothrix infection
F - rarely effective
70
71
Potassium Iodide is first line treatment for sporothrix
False - Itraconazole 100- 200 mg daily for 3 - 6 months
72
List the common Microsporum dermatophytes
Canis
Ferrugineum
Gypseum
73
What is the Epidermophyton dermatophyte?
Floccosum
74
What is the most common dermatophyte?
Trichophyton Rubrum
75
Which dermatophyte emerged in india with terbinafine drug resistance?
Trichophyton Indotineae
76
RF for tinea infection
SES
Occupation
Air conditioning
Use of footwear
Pets
77
RF for tinea capitus
Household exposure to tinea capitus or pedis
Environmental factors - contanimated hats / hair brushes etc
Down syndrome (tinea unguium)
M > F
Immunodeficency
78
Key features of Tinea Corporis
Dermatophyte infection of the trunk
Most common org: T rubrum and T mentagrophytes
Extent of inflammation depends on the causative organism and immune response
79
Clinical features of tinea corporis
Extent of inflammation depends on cauasative organism and host immue response
Arcuate, circinate, concentric and oval lesions
Central clearing
Leading scaly edge +/- pustules
80
Clinical variants of tinea corporis
Profunda
Nodular
Perifolliculitis
Majocchi granuloma
81
Dermatophyte mimic of erythmea gyratum repens?
Tinea imbricata
Concentric annular rings resembling erythema gyratum repens
82
Key features of Tinea Cruris
Dermatophyte infection of the groin / inner thighs
Common Org: Epidermophyton Floccosum, T. Rubrum and T mentagrophytes
M > F
RF: obesity, excessive perspiration, tinea pedis or onchychomycosis
83
What is Tinea Manuum?
Dermatophyte infection on the palm and interdigital spaces
84
Key organisms for Tinea Manuum?
T. Rubrum
T. Mentagrophytes
E. Floccosum
85
Key features and Dx?
Diffuse scaling of the palm of one hand, accentuation of the creases
Minimal inflammation
Dx: Tinea Manuum
86
Tinea Barbae key features
Dermatophyte infection of the beard
Normally from zoonotic dermatophytes - T. mentagrophytes and T. Verrucosum
87
Most common cause of tinea capitus
T. Tonsurans
88
Endothrix organisms
Trichophyton Tonsurans
Trichophyton Violaceum
Trichophyton gourvilli
89
Ectothrix Organisms
Microsporum Canis
Microsporum Audouinii
Microsporum Ferrugineum
Microsporum Gypseum
90
Dermoscopic clues to tinea capitus?
Alopecia
Corckscrew
Comma hairs
91
what is favus?
Favus or tinea favosa **is in most cases a severe form of tinea capitis. **
It is caused by the** dermatophyte fungus Trichophyton schoenleini**i and results in a honeycomb destruction of the hair shaft.
Hyphea and air spaces are seen within the hair shaft
Woodlight is blue - white
92
What are the major types of tinea pedis?
Moccasin
Interdigital
Inflammatory
Ulcerative
93
What is moccasin?
A clinical subtype of tinea pedis
Characterised by: diffuse hyperkeratosis, erythema, scaling and fissures
Org: Trichophyton rubrum and Epidermophyton floccosum
Rx: topical + urea / lactic acid
| Non0dermatophyte mimics = neoscytalidium hyalinum
94
What is tinea interdigital?
A subtype of tinea pedis (most common)
Characterised by erythema, scale, fissures and maceration in the web spaces
Org: Trychophyton interdigitale, trichophyton rubrum, E floccosum
95
What organism causes Inflammatory tinea pedis?
Trichophyton Mentagrophytes
96
Indicators of more severe nail disease for onychomycosis?
97
What are the complications for tinea capitus?
Secondary bacterial skin infection, whcih can lead to systemic bacterial infection
○ Common organisms include MSSA, MRSA, Group A Strep
Alopecia
○ This is often scarring and permanent
Spread of the tinea to other body sites
○ Tinea corporis / tinea facei etc
Spread of the tinea to other individuals
○ Anthophilic spread
Autoeczematisation (ID reaction)
98
What are the dermoscopy findings in tinea capitus?
99
Describe your findings
100
DDx of tinea capitus?
Alopecia Areata
Focal Psoraisis
Trichotilimania
Seborrhoeic dermatitis
Bacterial folliculitis
Disecting cellulitis of the scalp
101
What are the clinical features of onychomycosis?
Nail discoloration,
Subungual hyperkeratosis,
Onycholysis,
Splitting of the nail plate,
Nail plate destruction
102
What are the complicaitons of onychomycosis?
Pain,
Transmission of fungal infection to other body sites,
Transmission of fungal infection to other people
Secondary bacterial infection
ID reaction
Loss of the nail
Psychological distress
103
What are some cause of onychomycosis?
Trichophyton Rubrum
Trichophyton Mentagrophytes
Epidermophyton floccosum
Microsporum Canis
Candida spp.
Fusarium,
Aspergillus,
104
DDx on onychomycosis?
Psoriasis
Eczema
Trauma
Lichen Planus
Yellow nail syndrome
Paronychia congenita
