CC March 2016 Oropharyngeal Candiasis

echoecho's version from 2016-05-16 04:14


I= Section
Question Answer
Define?Superficial fungal infection most commonly caused by Candida albicans, although these can be involvement of other species
What percent of healthy adults have C. albicans colonization in the oral cavity?50
What will establish a diagnosis?1) viewing scrapings microscopically with potassium hydroxide and 2) identifying hyphae or culturing the scrapings
Is oropharyngeal Candiasis an acquired immunodeficiency syndrome (AIDS) - defining illness?No
What candida infection is considered an acquired immunodeficiency syndrome (AIDS) - defining illness?Candida esophagitis
List the predisposing factors for oropharyngeal Candiasis?1) broad spectrum antibiotics. 2) immunosuppression (HIV, chemotherapy or radiation therapy, corticosteroid use - inhaled or chronic oral, uncontrolled systemic disease, other immunosuppression states or diseases (malignancy), 3. Local factors (I'll fitting dentures, poor oral hygiene, xerostomia)
List the two presentations in the mouth? 1) the pseudo membranous variety. 2) atrophied form, also known as denture stomatitis, which occurs primarily in older persons and presents with erythema but no plaques
What is another presentation?Angular chieilitis presenting as fissures and erythema at the corners of the mouth
To mitigate the risk of oral Candiasis when using chronic inhaled corticosteroids should do what?Rinse oral cavity after inhalation
*** A study of mouth washing procedures found some benefit to _________ and _______ together compared to either alone? What eliminated more of the corticosteroid residue than delayed cleansing?Gargling, rinsing, immediate mouth washing
Compare the frequency of Candiasis between denture wearers and fully dentate individuals as to frequency of oral candidiasis?higher among denture users
Why is oral Candiasis higher among denture wearers?1)the denture base acts as a reservoir for a continuous reinfect ion of the oral mucosa and the upper denture 2) the confined space between the mucosa and the upper denture, inadequate fitting of the denture and the wearing of the denture throughout the night may all lead to the growth of Candida..
What is the chief characteristic of Candida denture stomatitis?inflammation of the oral mucosa, often without the typical white plaques
What is the prevalence of Candida denture stomatitis among denture wearers? 10-75%
What is the frequency of oral colonization?as high as 88%
The strophic mucositis in denture stomatitis often causes what?discomfort and burning of the mouth, resulting in difficulty eating and drinking, potentially leading to malnutrition, especially in the elderly
Can mild cases of oropharyngeal Candiasis resolve without medication especially if the patient addresses the underlying cause?yes
List the treatment options for oropharyngeal Candiasis that is mild?1) Clotrimazole (Mycelex) torches (10 mg 5 times daily) 2) Nystatin suspension 100,000 U/mL 4 times daily. 3) Nystatin pastille 200,000 units (1 or 2, 4 times daily)
List the treatment options for oropharyngeal Candiasis that is moderate to severe or recurrent?flu camisole (Diflucan) 100-200 mg (3 mg/kg) as a single dose daily
List the treatment options for oropharyngeal Candiasis that is refractory?1) first line = oral itraconazolr (Sporonox) or posaconazole (Noxafil). 2) second line = oral voriconazole (Vfend) or amphoteric in B. 3) third line = IV echinocandins (campo fungus (Cancidas) or amphoteric in B
List the treatment options for oropharyngeal Candiasis that is Denture related Candiasis?anti fungal therapy AND disinfection of the dentures (using more denture soaking solutions, Listerine or chlorhexidine gluconate
What is the treatment duration for acute and non recurrent cases?7-10 days
Oral Candiasis (thrush) is present in 2-5% of healthy infants and can develop within the first few weeks of life, true or false?true
Oral Candiasis is uncommon after the _____ years?first
Exposure to what increases the risk for development as well as for recurrence?antibiotics
Where do the whit lesions most commonly occur in the mouth?tongue and buccal mucosa
Persistence or recurrent infection for no obvious reasons (antibiotic use) should prompt the search for a possible underlying __________ condition?immunodeficiency
*** The recommended treatment is what?oral Nystatin suspension 4 times daily for 14 days
If an infant is being breast fed, what other treatment should be considered?mother's nipple treatment simultaneously (tyopical treatment with nystatin (Mycostatin) or ketoconazole so not to interrupt breastfeeding
Treatment of a breastfeeding mother with oral antifungals is not indicated unless what?she has diffusely painful breasts caused by intraductal candidal infection
What treatment is a single dose for the infant may be useful in difficult cases (although it is not approved by the FDA)?Fluconazole (Diflucan)
What is another option for treatment (75% cure rate at 11 days in one study), but it causes staining of clothing and teeth?Topical applied gentian violet
*** SUMMARY = List predisposing factors to oropharyngeal candiasis?1) broad-spectrum antibiotic 2) inhaled steroid use 3) immunosuppression 4) local factors
*** SUMMARY = The risk of oropharyngeal candiasis in uses of inhaled steroids can be decreased by doing what?gargling and rinsing immediately after adminstration
*** SUMMARY = what are the first-line treatment for oropharyngeal candidiasis?oral topical antifungals