Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
34 Cards in this Set
- Front
- Back
Where is Candida found commensally
|
mouth, GI tract, vagina
|
|
What elements of the host environment can determine Candida pathogenicity
|
tissue integrity, microbial flora, local immunity, systemic immunity, medical devices
|
|
Describe the role of tissue integrity in candida infections
|
mucosal barrier is crucial for proper defense, chemotherapy that destroys epithelial cells, invasive devices, or things that destroy endothelial integritiy can all contribute to candida proliferation and dissemination
|
|
How does the host microbial flora relate to candida infections
|
host flora is needed to keep candida at bay, use of antibiotics can create room for candida to prolierate (eg female taking AntiB's more suceptible to yeast infection)
|
|
What elements of host local immunity are crucial for candida defense
|
Tcell (CD4), secretory IgA, epithelial cells
|
|
What elements of host systemic immunity are crucial for candida defense
|
neutrophils, OPC cell mediated immunity, VVC epithelial cell
|
|
What host ligans plan important roles in candida colonization and infection
|
Dection 1 = glucan
Mannan Binding Lectin= mannan Transglutaminase= HWP1 |
|
What species of Candida is the most prominent pathogen? Second?
|
C.albicans followed by C. glabrata (but less suceptible to antifungals)
|
|
Which Candida species is known for cuasing oral mucosal infections in HIV pts
|
C. dubliniensis
|
|
Which speceis of candida is more common in hematologic malignancies and is often associated with prior antifungal therapy. It is also inherently resistant to azole antifungals
|
C. krusei
|
|
Which candida species is common in neonates, IVDU, and CVC usage. also colonizes hands of HCWs
|
C. parapsilosis (lowest mortality but unique drug resistance profile)
|
|
Which candida species is the most virulent of the non-albicans species and is common in pts with malignancies
|
C. tropicalis
|
|
Which candida species is often associated with immunocompromised pts and often resistant to amphotericin B
|
C. lusitaniae
|
|
define systemic candidiasis
|
invasion of candida beyond skin or mucous membrane
|
|
How does systemic candidiasis manifest? What are the consequences of this?
|
non-specific, presents like many other nosocomial infections, difficult to Dx and set up proper Tx quickly
|
|
Why is Dx'ing systemic Candidiasis difficult
|
only 50% of blood cultures from pts with BSI are positive
|
|
List some underlying diseases that can increase the risk for systemic candidiasis
|
neutropenia
malignancy transplantation burn diabetes |
|
List some iatrogenic factors that can increase the risk for systemic candidiasis
|
CVCs, antibiotics, surgery, hemodialysis, ventiliation, chemotherapy, corticosteroids
|
|
What is the most common cause of Candida BSI
|
central venous catheters (70%)
|
|
What are the three syndromes associated with urinary candidiasis (candida in the urine)
|
1. colonization (catheter)
2. cystitis (rare) 3. upper UT or kidney infection |
|
Is urinary candidiasis always clinically significant
|
No. There is no way to distinguish between colonization and infection. Most infections are asymptomatic and non-lethal
|
|
What are the two major syndromes associated with Candida Peritonitis
|
1. Peritoneal dialysis catheter related
2. Surgical/ trauma related |
|
What are some symptoms associated with vulvovaginal candidiasis
|
itching, soreness, discharge, external dysuria, superficial dyspareunia
|
|
What are some signs associated with vulvovaginal candidiasis
|
erthema, fissuring, discharge, edema
|
|
List some risk factors for Vulvovaginal candidiasis
|
diabetes, antibiotics, certain contraceptive methods, steroids, HIV, pregnancy, genetic predisposition (mannan binding lectin polymorphism)
|
|
What are the two primary risk groups for oral candidiasis
|
1. HIV
2. Non HIV (includes systemic and local) |
|
What are some systemic factors that lead to non HIV oral candidiasis risk
|
elderly, infancy, diabetes, malignancies, corticosteroids
|
|
What are some local factors that increase risk for non HIV associated oral candidiasis
|
dentures, Xerostomia (no saliva)
|
|
Describe the clinical presentation of oral candidiasis
|
white plaques, erthema, angular chelitis (cracked corners of the mouth), pain, weight loss (from poor nutrition),
|
|
T/F oral candidasis is a major risk for systemic candidiasis
|
false, oral candidiasis rarely spreads
|
|
T/F eosphageal candidiasis is just as common as oral
|
false, pt must have a severly compromised immune system for esophageal dissemination to occur
|
|
List some presenation os cutaneous candidiasis
|
occurs in warm, noist areas
intertrigo (axilla, groin, breasts), diaper rash, balanitis, perianal, folliculitis, nail |
|
How is candia diagnosed
|
microscopy showing small yeasts, white colonies on SDA
|
|
How can a candida infection be identified to the species level
|
-germ tube formation for C. albicans or C. dubliniensis
-Chlamydospores for C. albicans or C. dubliniensis -assimilation profile -CHROMagar -PNA FISH (peptide nucelic acid fluorescence in situ hybridization) |