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Year 2- Infectious Disease > Fungal Infections > Flashcards

Fungal Infections Flashcards

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1
Q

Fungal infections are described as being pooutunistic, what does this mean?

A

They tend to thrive when the patient’s immune systems are weaker

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2
Q

When may a patient have a weaker immune system and be at increased risk of a fungal infcetion?

A

Primary immunodeficiency
HIV/AIDS
Malignancy and transplants
Premature neonate

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3
Q

Another group of patients at risk of fungal infections are those with chronic lung conditions.

Which type of fungal infection may affect them?

A

Inhalation of fungi e.g. mould

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4
Q

What are the tow main types of fungal skin infection?

A

Candidiasis
Tinea

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5
Q

What is Candidiasis?

A

Yeast like infection
Uniform commensal of mouth/GIT
Opportunistic

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6
Q

What is tinea?

A

Superficial skin infection caused by dermatophytes

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7
Q

Candida is asymptomatic until when?

A

Until disrupted e.g. in lowering of the immune system or disrupted mucosal barriers

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8
Q

What are some of the risk factors for candida infection?

A

Moist areas
Skin folds
Obesity
Diabetes
Neonates
Pregnancy
Poor hygiene
Occupation in wet environments

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9
Q

Patients who have recently had which drug may be more likely to develop a Candida infection?

A

Patients on broad spectrum antibiotics

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10
Q

What type of rash is common in babies?

A

Nappy rash aka napkin dermatitis

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11
Q

What is genital candidiasis often known as?

A

Thrush

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12
Q

What are the symptoms of thrush?

A

Itch
Soreness and burning discomfort
Vulval oedema
Cottage cheese/white curd discharge
Bright red rash

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13
Q

What are some risk factors of thrush?

A

Just before and during menstruation
Obesity
Diabetes
Iron deficiency anaemia
Immunodeficiency
Recent course of broad spectrum antibiotics
High dose OCP/ oestrogen based HRT
Pregnancy

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14
Q

How is a diagnosis of thrush made?

A

Clinically but vaginal swab can be done

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15
Q

What is the management of thrush?

A

Clotrimazole - topical antifungal cream
Oral fluconazole
Supportive measures e.g. loose clothing, avoiding soap

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16
Q

What is non-specific balanitis?

A

Inflammation of the glans penis

->bacterial or candida infection

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17
Q

Treatment of candida balanitis?

A

Topical clotrimazole

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18
Q

What are the risk factors for oral candidiasis aka oral thrush?

A

Extremes of age
Immunocompromised
Diabetes
Dental prosthesis
Smoking
Poor oral hygiene
Local trauma
Nutritional deficiency
Impaired salivary function

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19
Q

Which two types of drugs increase risks of oral thrush?

A

Broad spectrum antibiotics
Inhaled or oral corticosteroids

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20
Q

What are the symptoms of oral thrush?

A

White or yellow plaques in mouth
Mild burning
Erythema
Altered taste
‘Furry tongue’

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21
Q

What is the management of oral thrush?

A

Topical antifungal e.g. nystatin or miconazole gel
Smoking cessation
Good oral hygeine

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22
Q

Systemic candida infections can occur in the immunosuppressed. Who would fall into this catergory?

A

Those with HIV, malignancy or those having chemo

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23
Q

What are some other risks of systemic candida infection?

A

Recent abdominal surgery
Renal failure
Low birth weight infants
Neutropoenia
Diabetes

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24
Q

Candidaemia?

A

Candida infection in the bloodstream

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25
Systemic candida infection can spread to any body part. When should you be clinically suspicious of a systemic candida infection?
Fever which doesn't respond to antibiotics
26
Invasive candidiasis?
Gut commensal, common bloodstream infection
27
How is a diagnosis of invasive candidiasis made?
Blood cultures
28
What is the treatment of invasive candidiasis?
IV/oral antifungals
29
What is tinea caused by?
Direct spread from infected individual or animal Indirect spread by clothing or bedding etc
30
What are some risk factors of tinea?
Hot humid environments Obesity Tight fitting clothing Immunocompromised Hyperhidrosis (excess sweating)
31
How do tinea infections usually present?
Scaly itchy skin
32
Upon examination of a tinea infection, what would be seen?
Single or multiple flat or slightly raised patches Typically central clearing Asymmetrical distribution
33
Investigations are not usually required for tinea infections but would could be done if unsure?
Skin flaking or swab
34
List some common types of tinea infection.
Athlete's foot Ringworm Tinea Capitis (scalp and hair)
35
What is the management of tinea infections?
Supportive e.g. loose fitting clothing, good hygiene Topical anti-fungal creams
36
How can a diagnosis of fungal nail infection by made?
Nail clippings to send off
37
What are the management options for fungal nail infections?
Can just be left Keep nails trimmed and have well fitting shoes Cotton absorbent socks Topical nail lacquer Oral terbinafine
38
If a patient in on oral terbinafine, what needs to be monitored?
LFTs
39
Aspergillus?
A type of mould
40
Where can aspergillus be found?
Soil, compost, other organic matter Dust and bedding Damp buildings Air conditioning systems
41
How is aspergillus transmitted?
Inhalation by spores
42
Inhalation of aspergillus can be harmful to those with which underlying health conditions?
Cystic fibrosis COPD TB Sarcoidosis Weakened immune syste,
43
What does aspergillus cause?
Aspergillosis
44
What are the symptoms of Aspergillosis?
Cough SOB Wheeze Pyrexia General malaise Headache
45
What are the four types of aspergillosis?
Allergic bronchopulmonary aspergillosis Chronic pulmonary aspergillosis Aspergilloma Invasive pulmonary aspergillosis
46
Which type of aspergillosis is most common in patients with asthma and cystic fibrosis?
Allergic bronchopulmonary aspergillosis
47
What is allergic bronchopulmonary aspergillosis due to?
Allergy to aspergillus mould
48
What are the symptoms of allergic bronchopulmonary aspergillosis?
Cough > 3 weeks
49
What can allergic bronchopulmonary aspergillosis lead to?
Pulmonary fibrosis
50
How can a diagnosis of allergic bronchopulmonary aspergillosis be made?
Bloods Sputum culture Positive skin test Positive serology CXR/CT
51
What is the management of allergic bronchopulmonary aspergillosis?
Oral long term high dose prednisolone Antifungal treatment
52
Chronic pulmonary aspergillosis means symptoms have been ongoing for > 3 months. Which type of patients does it affect?
Patients with underlying lung conditions
53
How can chronic pulmonary aspergillosis present?
Exacerbations not responding to antibiotics Decline in lung function Increased resp. symptoms
54
How is a diagnosis of chronic pulmonary aspergillosis made?
Sputum culture Refer for CXR
55
What is used in the management of chronic pulmonary aspergillosis?
Oral anti-fungals
56
Aspergilloma?
Fungal mass which grows in lung cavities
57
Who is at risk of an aspergilloma?
Patients with: TB Sarcoidosis Bronchiectasis After pulmonary infection Bronchial cyst or bullae
58
How does aspergilloma present?
Commonest presentation is haemoptysis Cough and fever sometimes Can be asymptomatic and only picked up on CXR
59
Who is at risk of acute invasive pulmonary aspergillosis?
Neutropenic patients Post transplant patients Patients w defects in phagocytes
60
How can acute invasive pulmonary aspergillosis present?
Any organ can be involved so symptoms vary but: Cough SOB Fever Haemoptysis Pleuritic chest pain Nasal congestion and pain, sinusitis can develop
61
How can acute invasive pulmonary aspergillosis spread?
Haematogenously -> can spread to kidneys, brain, GIT, skin, eyes so presentation varies High mortality rate 50%
62
What is the management of acute invasive pulmonary aspergillosis?
IV anti-fungals
63

Year 2- Infectious Disease (12 decks)

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