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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)