Tags: Candidiasis

Dermatophytes

Essentials of Diagnosis Characteristic pattern of inflammation on glabrous skin surfaces. The active border of infection is scaly, red, and slightly elevated. Wet mount preparation with potassium hydroxide (10-20%). Skin scraping of the active border shows branching, translucent, rod-shaped filaments (hyphae) in keratinized material under low-power microscopy (10-40×). Hyphae are uniformly wide and regularly septated. Wood’s light examination (UV light at 365 nm) shows blue-green fluorescence for Microsporum canis and Microsporum audouinii. Trichophyton schoenleinii is pale green, and tinea versicolor shows white-yellow fluorescence. Culture should be performed with hair, nail, and skin specimens from particularly inflammatory lesions, to make a definitive mycologic diagnosis. General Considerations Dermatophytes are molds that infect keratinized …

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Candida Species

Essentials of Diagnosis Characteristic appearance of yeast and hyphae on KOH preparations. Formation of germ tubes in serum is presumptive diagnosis for Candida albicans. Cultures must be interpreted with caution because positive culture may represent colonization rather than infection. Serology not useful. General Considerations A. Epidemiology. Candida organisms are commensal with humans and, in the absence of alterations in host defense mechanisms, usually do not cause disease. Candida exists as normal flora within the oral cavity, throughout the gastrointestinal (GI) tract, in expectorated sputum, in the vagina, and in the bladder of patients with indwelling catheters. There are >150 species within the genus Candida, although the majority are not known to …

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Candidemia & Disseminated Candidiasis

Candidemia may present in a variety of fashions, ranging from asymptomatic to fulminant sepsis. The candidemic patient generally has risk factors for infection, such as malignancy, chemotherapy-induced neutropenia, organ transplantation, GI surgery, burns, indwelling catheters, or exposure to broad-spectrum antibiotics. Disseminated candidiasis must be assumed to be present in those with positive blood cultures, although negative cultures do not preclude the possibility of disseminated disease. Dissemination usually manifests with many microabscesses involving multiple organs, especially the liver, spleen, and eye, but almost any organ may be involved (Box 2). Diagnosis Candidemia is diagnosed by recovering Candida species in blood culture. Candidemia may be isolated or may occur in the setting of …

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Candiduria, Candida Cystitis & Urinary Tract Candidiasis

The presence of Candida spp. in the urine is common and does not necessarily represent infection. Candiduria is commonly associated with antibiotic use, indwelling urinary catheters, and diabetes mellitus and frequently resolves if predisposing factors can be corrected. Patients are generally asymptomatic, although some will have symptoms similar to bacterial cystitis, with dysuria, frequency, and urgency (Box 2). Urinalysis shows fungal elements and may reveal pyuria. At cystoscopy, the mucosa of the bladder typically has an inflamed appearance with adherent white plaques that may be removed with the scope. Candida spp. may also cause urethritis, typically in male sexual partners of women with vaginal Candida infection, as well as higher urinary …

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Esophageal Candidiasis

Clinical Findings A. Signs and Symptoms. Candida infection of the esophagus can present with a range of clinical findings (Box 1). Between 20 and 50% of patients may be asymptomatic. Others will note dysphagia, odynophagia, epigastric pain, nausea and vomiting, or hematemesis. Fever may be present. Frequently, patients will have concurrent symptoms of oral thrush. Physical exam of patients with esophagitis yields few clues to its diagnosis. Oral thrush is seen in the majority. B. Imaging. Barium studies and endoscopy are both useful for diagnosis of Candida esophagitis. The findings found with these methods are described in the diagnosis section. C. Differential Diagnosis. Candida esophagitis may be confused with other causes …

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Oral Candidiasis (Oral thrush)

Clinical Findings A. Signs and Symptoms. Candida infections of the oral cavity are relatively common and may present in several forms. Any of the forms may be asymptomatic or may cause soreness and burning. The most common, acute pseudomembranous candidiasis, or oral thrush, presents with multiple white patches on the tongue, palate, and other areas of oral mucosa. These lesions may be easily removed by scraping with a tongue blade to reveal an erythematous, irritated mucosa (Box 1). In addition to oral thrush, oral Candida infection occurs in several distinct forms. Acute atrophic candidiasis causes erythematous mucosa found typically on the palate and tongue, chronic atrophic candidiasis results in erythema and …

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Candida Dermatitis (Candida rash)

Clinical Findings A. Signs and Symptoms. Skin infections with Candida are common and may manifest in a variety of forms. Intertrigo occurs in warm, moist areas of skin, such as under the breast, in the groin, and in the axilla. Initially pustular or vesicular, lesions eventually become confluent to form an erythematous, macerated area of skin with a scalloped border and satellite lesions (Box 1). Erosio interdigitalis blastomycetica is similar to intertrigo but involves the areas between the fingers and toes. Paronychia is infection of the nail bed, seen more commonly in diabetics and people who frequently immerse their hands in water. Candida spp. may cause onychomycosis, particularly in HIV-infected patients. …

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Secondary Syphilis

Clinical Findings A. Signs and Symptoms. The secondary stage of syphilis occasionally overlaps with the primary phase but usually begins ~ 6 weeks after resolution of the chancre; however, it can develop as late as 6 months after infection (see Box  1). Most patients have some degree of skin or mucocutaneous involvement. A faint and evanescent macular rash of the trunk and abdomen known as roseola syphilitica is sometimes seen initially. A generalized, symmetric, nonpruritic rash consists of some combination of erythematous or copper-colored macular, papular, papulosquamous, or pustular lesions. These lesions can be found on the palms, soles, genitalia, and oral mucous membranes. The rash of syphilis often provides a …

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Norfloxacin: Side Effects

See also Fluoroquinolones Norfloxacin is a fluoroquinolone antibacterial drug with properties similar to those of ciprofloxacin, although less potent in vitro. Norfloxacin inhibits CYP1A2 and can therefore enhance the effects of other drugs by reducing their clearance. Comparative studies In a double-blind, multicenter study 171 patients who had acute pyelonephritis were given intravenous cefuroxime for 2-3 days, followed by ceftibuten 200 mg bd or norfloxacin 400 mg bd for 10 days. There were fewer bacterial relapses after oral norfloxacin than ceftibuten. Adverse events were reported by 47% of the patients taking ceftibuten and by 38% of those taking norfloxacin. This difference was not significant, but diarrhea or loose stools occurred more …

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Buy Without Prescription Sporanox (Itraconazole) 100mg

Itraconazole: Side Effects See also Antifungal azoles Itraconazole is a triazole antifungal drug. It is used orally to treat oropharyngeal and vulvovaginal candidiasis, pityriasis versicolor, dermatophytoses unresponsive to topical treatment, and systemic infections, including aspergillosis, blastomycosis, chromoblastomycosis, cocci-dioidomycosis, cryptococcosis, histoplasmosis, paracocci-dioidomycosis, and sporotrichosis. It is also used to prevent fungal infections in immunocompromised patients. Pharmacokinetics The systemic availability of itraconazole and the bioequi-valence of single 200 mg doses of itraconazole solution and two capsule formulations have been evaluated in a crossover study in 30 male volunteers. Itraconazole and hydroxyitraconazole were 30-37% more available from the solution and were greater than from either capsule formulation. However, the values of Cmax, fmax, and …

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