MIC Flashcards
(35 cards)
Superficial fungal infections
Candida - yeast
Dermatophytes- filamentous fungi
Types of candida
Candida – a yeast
C. albicans is the most common
C. glabrata common, less susceptible to azoles
C. auris, unusual but often ‘resistant’
Worldwide emergence, MOH notifiable
___________ recurrent infection in HIV
Candidiasis
Predisposing factor of candidiasis
Antibiotics
Immunocompromised
Infancy, old age, pregnancy
Management of candidiasis
Address precipitating factors
Stop antibiotics
Good hygiene, dry skin, fresh nappies
Reduce steroids
Test for HIV
Topical or systemic antifungal drugs
- Clotrimazole
- Azoles
- Echinocandins (anidulafungin)
Dermatophytes
Filamentous fungi
SKIN HAIR NAIL FUNGAL INFECTION
Sources:
humans, animals, or environment
Ring worm’ – skin
‘Athlete’s foot’ – soles, and toe webs
Systemic candiasis
Antibiotics
Immunocompromised
Infancy, old age, pregnancy
In addition, …
1) GIT perforation / surgery
2) Intravascular line
3) Preterm neonates
Aspergillosis
A filamentous fungus
Aspergillus fumigatus is the most common
… many other species
Invasive aspergillosis
- Immunocompromised patients
**Neutropaenia ***
Cultures less predictive
Biopsy more specific
Antigen tests
CLOSTRIDIUM
Clostridium perfringens (gas gangrene, see prev lecture)
Clostridium tetani - tetanus
Clostridium botulinum - botulism
Clostridium tetani found in
Found in animal faeces, contaminated soil
Cause of tetanus
Superficial cut, contaminated splinter, thorn prick in gardeners….
Presentation of tetanus
Descending involvement of the nervous system –toxin causes
sustained excitation of motor neurons, causing motor spasms
Stiffness
Lockjaw
sardonic grin (a sneering grin)
Opisthotonus (extreme arching of the back)
Clostridium botulinum
Cause of botulism (relaxation of muscle)
Severe, often fatal food poisoning
Presentation of botulism
Eyes affected first (double vision, drooping eyelids)
Descending motor loss with flaccid paralysis
Speech and swallowing difficulty
Breathing difficulty
Death from cardiac or respiratory failure
VIETNAMESE TIME BOMB
Burkholderia pseudomallei
Reported cases of melioidosis in American soldiers who fought in the Vietnam war
(onset of infection 62 years later
Burkholderia pseudomallei – what is the significance?
Major cause of death
Burkholderia pseudomallei risk factors
diaebets
alcohol excess
renal disease
chronic lung disease
Fungi diagnostic test
microsopy
culture and sensitivity
Leptospirosis spread through
Spread through the urine of infected animals, which can get into water
or soil and can survive for weeks to months. (especially rats urine)
Leptospirosis – how do humans get infected?
Humans can become infected through:
*Contact with urine / body fluids from infected animals.
*Contact with water, soil, or food contaminated with the urine of infected animals.
Bacteria -> through skin or mucous membranes (eyes, nose, mouth), especially if the skin is broken from a cut or scratch.
Drinking contaminated water can also cause infection.
Outbreaks of leptospirosis are usually caused by exposure to contaminated water, such as floodwaters.
Person to person transmission is rare.
Leptospirosis – risk factors
it is an occupational hazard for people working outdoors or with animals, such as:
*Farmers
*Mine workers
*Sewer workers
*Slaughterhouse workers
*Veterinarians and animal caretakers
*Fish workers
*Dairy farmers
*Military personnel
The disease has also been associated with swimming, wading, kayaking, and rafting in contaminated lakes and rivers.
Leptospirosis – clinical features
High fever
*Headache
*Rigors
*Myalgia
*Vomiting
*Jaundice (!!)
*Red eyes (!!)
*Abdominal pain
*Diarrhoea
*Rash
If a second phase occurs, it is more severe; the person may have hepatorenal failure (Weil’s disease),
meningitis, bleeding, haemoptysis.
Toxoplasmosis – serious implications
Mother-to-child (congenital)
*If a woman has been infected before becoming pregnant, the unborn child will generally be
OK due to maternal antibody.
*If a woman is pregnant and becomes newly infected with Toxoplasma during or just before
pregnancy, congenital transmission can occur.
*The earlier in pregnancy when transmission occurs, the more severe the damage to the baby
Potential results can be :
*miscarriage
*stillborn child
*a child born with signs of toxoplasmosis (retinitis, brain damage with calcification,
microcephaly, jaundice, hepatosplenomegaly)
*Infants infected before birth often show no symptoms at birth but may develop them later in life with potential vision loss, mental disability, and seizures.
- immunocompromised patient -> reactivation of Toxoplasma infection
Symptoms - fever, confusion, headache, seizures, nausea,
and poor coordination.
Toxoplasmosis – signs & symptoms
Generally, asymptomatic or mild, self-limiting illness in
the immunocompetent.