Fungal Infection

Question 1

Also known as mycosis

Answer 1

Candidiasis

Question 2

Mycosis is tradionally divided according o the part of the body affected:

Answer 2

Superficial
Subcutaneous
Systemic

Question 3

Most common fungal infection in humans

Answer 3

Candidiasis

Question 4

Causative agent of candidiasis

Answer 4

Candida (monilia) albicans

Question 5

Most opportunistic infection

Answer 5

Candidiasis

Question 6

Two major category of candidiasis

Answer 6

Primary oral
And
Secondary oral

Question 7

A type of candidiasis that infection exclusively confined to oral and perioral tissues

Answer 7

Primary oral candidiasis

Question 8

A type of candidiasis that oral lesion as a manifestation of systemic mucocutaneous candidiasis

Answer 8

Secondary oral candidiasis

Question 9

Characterized by the soft, white, slightly elevated plaques

Occuring in the buccal mucosa and tongue, but also seen on the palaet, gingiva, and floor of the mouth

Resembling milk curds

Plaque can usually be wiped away with a gauze

Answer 9

Pseudomembranous (thrush) candidiasis

Question 10

Most common form of candidiasis

Answer 10

Pseudomembranous (thrush)

Question 11

Occurrence of this lesion in a healthy individual indicates the presence of immune suppression especially HIV infection

Also occur in patients receiving systemic corticosteroid therapy

Answer 11

Pseudomembranous (thrush)

Question 12

Redness is due to increased vascularity

Distinguished from erythroplakia by its diffuse border wherein erythroplakia the border are sharp and well demarcated

Consistently painful

Answer 12

Erythematous (candidiasis)

Question 13

Occurs as a sequela to a course of broadspectrum antibiotics, corticosteroid or any disease which suppresses the immune system, more commonly in HIV disease

Answer 13

Erythematous (antibiotic mouth sore)

Question 14

A candidiasis that occurs due to the loss of filiform papillae

Answer 14

Erythematous (antibiotic mouth sore)

Candidiasis ^

Question 15

Show pinpoint hyperemic macules or more generalized erythema

Erythema often exhibits a distinct border corresponding to the outline of the denture base

Answer 15

Denture stomatitis

Question 16

Inflammatory condition characterized by erythema localized to denture-bearing areas of the palate and alveolar ridges

Answer 16

Denture stomatitis ( chronic atrophic candidiasis )

Question 17

Consists of firm, white persistent plaques, usually on the lips, tongue, and cheeks and appear similar to lukoplakia

Answer 17

Chronic hyperplastic candidiasis

Question 18

“Leukoplakia” type of candidiasis that is a possible premalignant potential

Answer 18

Chronic hyperplastic candidiasis

Question 19

Exhibits a predilection for the anterior buccal mucosa, although the tongue, palate, or other sites also may be involves

Some exhibit a finely ‘speckled’ red and white appearance

Answer 19

Chronic mucocutaneous candidiasis

Question 20

Chronic involvement of the sin, scalp, nails and mucous membranes

Exhibit varying abnormalities in the immune system - impaired cell mediated immunity, isolated IgA deficiency, and reduced serum candidacial activity

Usually resistant to the common form of treatment

Answer 20

Chronic mucocutaneous candidiasis

Question 21

Histologically, candidiasis shows the presence of ____ cells and ____ or mycelia in the superficial and deeper layers of involved epithelium

Answer 21

Yeast cells

Hyphae

Question 22

Treatment of candidiasis

Answer 22

Prescribing antifungal medication and addressing the underlying predisposing factors

Nystatin has been beneficial in the treatment of candidiasis

Question 23

Causative gent of histoplasmosis

Answer 23

Histoplasma capsulatum

Question 24

Characterized by a chronic low-grade fever, productive cough, splenomegaly, hepatomegaly and lymphadenopathy, since the organisms have a special predilection for the reticuloendothelial system and chiefly involve the spleen, liver, lymph nodes, and bone marrow

Answer 24

Histoplasmosis

Question 25

Histoplasmosis is classified clinically into:

Answer 25

Acute primary pulmonary Chronic pulmonary Disseminated forms

Question 26

Appears a nodular, ulcerative or vegetative lesions on the buccal mucosa, gingiva, tongue, palate or lips Ulcerated areas are usually covered by a nonspecific gray membrane which is indurated with raised and rolled out borders resembling carcinoma

Answer 26

Histoplasmosis

Question 27

Histologically, multinucleated giant cells are usually see in association with the granulomatous inflammation It is found in large numbers in phagocytic cells and appears as tiny intracellular structure

Answer 27

Histoplasmosis

Question 28

Treatment of histoplasmosis

Answer 28

Depends on the severity of the disease Disseminated histoplasmosis is usually fatal without treatment Management includes antifungal therapy and addressing underlying cause of immunodeficiency

Question 29

Causative agent of blastomycosis

Answer 29

Blastomyces dermatitidis

Question 30

North american _____ ; Gilchrist’s disease

Answer 30

Blastomycosis

Question 31

North american blastomycosis: ___

Answer 31

Gilchrist’s disease

Question 32

It is most common in men May occur either in a cutaneous form or in a systemic form involving bones, liver, lungs, subcutaneous tissues and other oragns Mainfl affects the lungs Skin lesion may appear as plaques, pustules, or nodules, with associated ulceration, a waty surface, crusting, and/or exudate

Answer 32

Blastomycosis

Question 33

What organ mainly affects blastomycosis

Answer 33

Lungs

Question 34

Oral ulceration is present Exhibit a gradually enlarging ulcer with a rolled border or an erythematous nodules with granular to warty surface Tongue, buccal mucosa, or other sites may be involved

Answer 34

Blastomycosis

Question 35

Histologically, inflamed conective tissue shows occasional giant cells and macrophages and the typical round organism, often budding, which appear to have a doubly refractive capsule

Answer 35

Blastomycosis

Question 36

Treatment of blastomycosis

Answer 36

Depends on the severity of the disease Disseminated extra pulmonary blastomycosis typically receive systemic antifungal therapy

Question 37

South american blastomycosis:

Answer 37

Lutz’s disease

Question 38

Lutz’s disease

Answer 38

South americal blastomycosis

Question 39

Causative agent of paracoccidiomycosis

Answer 39

Blastomyces (paracoccidioides) brasiliensis

Question 40

Acquired by inhalation of dust containing spores of the fungus - the contamination probably occuring from excreta of birds such as pigeons. Starlings and blackbirds

Answer 40

Paracoccidiomycosis

Question 41

What is the chief difference between north american and south american bastomycosis

Answer 41

Size of the causative organism

Question 42

May be solitary or multifocal Can involve the gingiva, palate, lips, buccal mucosa, tongue, or other sites Mucosa typically exhibits erythema, a granular (or “mulberry-like() surface, or hemorrhagic foci, and/or ulceration

Answer 42

Paracoccidiomycosis

Question 43

Often show multiple daughter buds on the parent cell, resulting in an appearance that has been described as resembling “Mickey Mouse Ears”

Answer 43

Paracoccidiomycosis

Question 44

Treatment for paracoccidiomycosis

Answer 44

Mild to moderate - Intraconazole or sulfamethoxazole-trimethoprim Severe - amphoteicin B

Question 45

Torulosis, European Blastomycosis

Answer 45

Cryptococcus

Question 46

Causative agent of cryptococcosis

Answer 46

Cryptococcus neoformans (torula histolytica) & cryptococcus bacillispora

Question 47

Irganisms appear to be harbored by pigeons Opportunistic infection - increase in immunsuppressed individuals Skin lesion appear as multiple brown papules which ultimately ulcerate

Answer 47

Cryptococcosis

Question 48

Oral lesion are relatively rare, they have been described either as craterlike, nonhealing ulcers that are tender on palpation or as friable papillary erythematous plaques

Answer 48

Cryptococcosis

Question 49

Yeast appears as a round-to-ovoid structure, surrounded by a clear halo that represents the capsule, sometimes described as “tissue microcyst”

Answer 49

Cryptococcosis

Question 50

Treatment of cryptoccosis

Answer 50

Systemic antifungal therapy (amphotericin B, fluconazole or itraconazole)

Question 51

Valley fever, san joaquin valley fever

Answer 51

Coccidiomycosis

Question 52

Causative agent of coccidiomycosis

Answer 52

Coccidloides immitis

Question 53

Two basic form of coccidiomycosis disease

Answer 53

Primary non disseminated and progressive disseminated

Question 54

Coccidiomycosis Develop manifestations suggestive of a respiratory disease such as cough, pleural pain, headache and norexia It is self limiting and runs its course within 10-14 days

Answer 54

Primary nondisseminted

Question 55

Coccidiomycosis Organism spreads hematogenously to extrapulmonary sites

Answer 55

Progressive disseminated

Question 56

Lesions of the oral mucosa and skin are proliferative granulomatous and ulcerated lesions; may present as an ulcerated tongue nodule, erythematous granular mucosal mass, or osteomyelitis of the jaw

Answer 56

Coccidiomycosis

Question 57

Large mononuclear cells, lymphoctes and plasma cells predominate Endospores within the large spherules can usually be identfied

Answer 57

Coccidiomycosis

Question 58

Treatment of coccidiomycois

Answer 58

Systemic antifungal therapy (e.g., fluconazole, itraconazole, amphotericin B)

Question 59

Phycomycosis, zygomycosis

Answer 59

Mucormycosis

Question 60

Causative agent of mucormycosis

Answer 60

Mucorales and entomophthorales

Question 61

Main types of phycomycosis infection occur in human beings

Answer 61

Superficial (localized) - involves external ear, fingernails and the skin Visceral (disseminated) - pulmonary - gastrointestinal - rhinocerebral - greatest interest to the dental profession

Question 62

Early clinical manifestation of the disease - appearance of a reddish black nasal turbinate and septum with a nasal discharge

Answer 62

Mucormycosis

Question 63

Necrosis may extend to the paranasal sinuses and orbital cavity, with the development of sinus tracts and sloughing of tissue Present as a mass in the maxilla,m resembling carcinoma of the antrum

Answer 63

Mucormycosis

Question 64

Histologic feature. Large nonseptate fungal hyphae characteristic of themucormycotic organism

Answer 64

Mucormycosis

Question 65

Treatment of mucormycosis

Answer 65

Surgical debriment Lipid formulations of amphotericin B Addressing underlying risk factors

Question 66

Causative agent of aspergllosis

Answer 66

Aspergillus spp.

Question 67

Aspergillosis that usually affects a normal host, appearing either as an allergic reaction or a cluster of fungal hyphae

Answer 67

Noninvasive aspergillosis

Question 68

Aspergillosis that may be seen in a normal host, but a more extensive infection is often evident in the immunocompromised patient

Answer 68

Localized invasive aspergillosis

Question 69

Two most commonly aspergillosis encountered species in the medical seeting

Answer 69

A. Flavus A. Fumigatus - responsible for most case of aspergillosis

Question 70

Disease may appear as an allergy affecting either the sinuses (allergic fungal sinusitis) or the bronchopulmonary tract Fungus ball (mycetoma, aspergilloma) represents a mass of fungal organism within a body cavity Examination may show gingival ulceration and palatal swelling with a gray to vilaceous hue

Answer 70

Aspergillosis

Question 71

Fungal hyphae and a fruiting body of the mucormycotic organism

Answer 71

Aspergillosis

Question 72

Treatment of aspergillosis For immunocompetent host - voriconazole - alternative drug - liposomal amphotericin B or capsofungin For immunocompromised patients - aggressive debridement o necrotic tssue, combined with systemic antifungal therapy

Answer 72

Aspergillosis