RTRMF – BSN LEVEL III
MARINURSE AND FRIENDS
NCM 112: MEDICAL-SURGICAL NURSING
F#3
LECTURER: SIR ANDRE DE VEYRA
FUNGAL INFECTIONS
ACTINMYCOSIS
ALSO KNOWN AS:
------------------------------------------------------------
CAUSATIVE AGENT:
Bacterium actinomyces israelli
INCUBATION PERIOD:
------------------------------------------------------------
SOURCE OF INFECTION:
------------------------------------------------------------
MODE OF TRANSMISSION:
------------------------------------------------------------
PERIOD OF COMMUNICABILITY:
------------------------------------------------------------
PATHOGNOMONIC SIGN:
------------------------------------------------------------
2.
Fever
3.
Weight loss
4.
Lumps on the face and neck
1. Bacterial culture and pathology
2. MRI
DIAGNOSTICS:
3. Immunoassay
1.
2.
3.
4.
5.
6.
TREATMENT:
RISK FACTORS:
Penicillin
Clindamycin
Erythromycin
Doxycycline
may be prescribe to patients allergic to penicillin
Sulfonamides Sulfamethoxazole - 2-4 g/kg
I&D and removal of abscess
It may resemble a fungus but the causative agent is a bacterium
⎯
1.
Poor oral hygiene
2.
Periodontal diseases
3.
Radiation therapy
4.
Trauma (jaw fracture)
5.
Appendectomy
6.
Immunosuppression
7.
Malnutrition
COMPLICATIONS:
1.
It may affect surrounding bones and tissues
2.
Meningitis
PREVENTION:
1.
Good oral hygiene
CAUSATIVE AGENT:
ASPERGILLOSIS
Bacterium actinomyces israelli
commonly found in the nose, throat and commonly affects
⎯
the face and neck.
Gram positive, nonacid fast, anaerobic microaerophilic
⎯
bacteria
This does not normally cause a disease but however, this
⎯
ALSO KNOWN AS:
---------------------------------------------------------------
CAUSATIVE AGENT:
Aspergillus (common cold)
INCUBATION PERIOD:
---------------------------------------------------------------
SOURCE OF INFECTION:
---------------------------------------------------------------
MODE OF TRANSMISSION:
---------------------------------------------------------------
PERIOD OF COMMUNICABILITY:
may only lead to a disease in particular patient such as
immunocompromised,
immunosuppressive
HIV/AIDS,
drugs,
patients
chemotherapy,
taking
radiation
therapy etc.
Because this normally would colonize the mouth, the
⎯
digestive and genital tracts, and when the immune system
starts to lower its function or starts to back down, that is
the time where it would cause a disease.
TYPES:
1.
Cervicofacial actinomycosis - which would usually
--------------------------------------------------------------1. Chest x-ray
DIAGNOSTICS:
2. CT scan
3. Sample fluid for analysis
4. Tissue biopsy
TREATMENT:
⎯
---------------------------------------------------------------
NOT CONTAGIOUS
CAUSATIVE AGENT: Aspergillus (common cold)
⎯
Breathed by people bust does not commonly cause a disease
⎯
It would only cause a disease in immunocompromised
patients.
follow after a dental infection
2.
Pelvic actinomycosis - which would normally occur in
women with IUD
3.
Pulmonary actinomycosis - usually found in people who
are smoking and poor dental hygiene, manifestations are
as follows:
a.
Coughing
b.
Chest pain
c.
Excessive sinus itching
CLINICAL MANIFESTATIONS
1.
Painful abscess (mouth, lungs, breast, GI tract), “Lumpy
Jaw”
⎯ This painful abscess would grow larger and may penetrate
the surrounding bones, and muscles and may leak with pus,
which contains characteristic granules, such as Sulfur
granules filled with bacteria.
Page 1 of 7
RTRMF – BSN LEVEL III
MARINURSE AND FRIENDS
NCM 112: MEDICAL-SURGICAL NURSING
LECTURER: MR. ANDRE CARLO DE VEYRA
TYPES:
1.
6.
Cutaneous or Skin Aspergillosis - which may enter in
Allergic bronchopulmonary aspergillosis (ABPA)
the break of skin integrity.
-
undergone surgery, burns
Inflammation of the lungs and allergy symptoms
such as:
7.
a. Coughing
F#3
Examples: People who
Invasive Aspergillosis
⎯ serious infection
b. Wheezing
⎯ affects immunocompromised people
c. SOB
⎯ Affects the lungs but also spread to other parts of
d. Fever
the body
• RISK FACTORS:
a. Fever
a. Cystic fibrosis
b. Chest pain
b. Asthma
c. Cough
• Aspergilloma- is a fungus ball that colonizes in a
d. Hemoptysis
healed lung scar or abscess from a previous disease.
e. SOB
•
AT RISK:
a. Chemotherapy
b. Organ transplant
c. High doses of corticosteroids
2.
Allergic Aspergillus Sinusitis - causes inflammation in
the sinuses and symptoms such as:
a. Drainage
b. Stuffiness
c. Rhinorrhea
d. Headache
e. Reduced ability to smell
3.
Azole-Resistant Aspergillus Fumigatus - One species of
aspergillus fumigatus will become resistant to certain
medicine used in the treatment
4.
Aspergilloma - ball of aspergillus grown in lungs or
sinuses, does not spread to other part of the body
a. Cough
b. Hemoptysis
c. SOB
DIAGNOSTIC TESTS
• Risk factor: TB
5.
Chronic Pulmonary Aspergillosis
⎯ Causes cavities in the lungs
⎯ Aside
from
formation
the
found
in
ball
the
lungs, there may be, or it
may lead to cavities in the
lungs.
This
happens
in
commonly
long
term
aspergillosis (3 months or
more)”. Aspergilloma may also be present.
a. Weight loss
b. Cough
c. Hemoptysis
1.
Chest x-ray
2.
CT scan
3.
Sample fluid for analysis
4.
Tissue biopsy - for microscopic exam or fungal culture
MANAGEMENT:
1.
Discontinue immunosuppressive drugs
2.
Severe cases may need surgery
PREVENTION:
1.
Avoid areas with a lot of dust
2.
Avoid activities with close contact to soil or dust (wear
mask or gloves)
3.
Clean injury with soap and water
d. Fatigue
e. SOB
•
RISK FACTORS:
a. TB
b. COPD
c. Sarcoidosis
Page 2 of 7
RTRMF – BSN LEVEL III
MARINURSE AND FRIENDS
NCM 112: MEDICAL-SURGICAL NURSING
LECTURER: MR. ANDRE CARLO DE VEYRA
BLASTOMYCOSIS
ALSO KNOWN AS:
---------------------------------------------------------------
CAUSATIVE AGENT:
Blastomyces
INCUBATION PERIOD:
3 weeks – 3 months
SOURCE OF INFECTION:
---------------------------------------------------------------
F#3
• Severe blastomycosis
- Can spread to the skin, bones, joints, CNS (brain and
spinal cord)
Breathing microscopic fungal spores from the
MODE OF TRANSMISSION:
air after participating in activities that disturb
the soil, exposed to decomposing material
such as wood, leaves etc.
PERIOD OF COMMUNICABILITY:
---------------------------------------------------------------
PATHOGNOMONIC SIGN:
--------------------------------------------------------------History, symptoms, and PE; Chest X-ray; CT
DIAGNOSTICS:
scan of the lungs; Tissue biopsy; Culture of
fluid from respiratory tract; Blastomyces
Urine Antigen
TREATMENT:
⎯
1. Itraconazole- for mild to moderate
cases (200 mg tid for 3 days, 200 mg OD
or bid for 6-12 mos)
2. Antifungal- may last 6 mos-1 year
3. Amphotericin B- for severe cases
Like aspergillosis, it is NOT CONTAGIOUS.
COMPLICATIONS:
1.
Brain abscess
2.
Epidural abscess
3.
Meningitis
4.
Bone lesions
5.
Genital lesions (epididymal swelling, deep perineal
discomfort, and prostatic tenderness)
CAUSATIVE AGENT:
BLASTOMYCOSIS
Blastomyces
⎯
commonly live in moist soil and commonly found in
ALSO KNOWN AS:
SAN Joaquin Fever, Valley Fever
decomposing matters such as wood or leaves.
CAUSATIVE AGENT:
Coccidiodes immitis, Coccidiodes posadassii
INCUBATION PERIOD:
1-3 weeks
SOURCE OF INFECTION:
--------------------------------------------------------------Breathing microscopic fungal spores from the
MODE OF TRANSMISSION:
air after participating in activities that disturb
the soil
TRANSMISSION: Breathing microscopic fungal spores from air
after participating in activities that disturb the soil, exposed to
PERIOD OF COMMUNICABILITY:
---------------------------------------------------------------
PATHOGNOMONIC SIGN:
--------------------------------------------------------------Enzyme immunoassay, Immunodiffusion,
DIAGNOSTICS:
1.
Fever (common)
2.
Cough
3.
Night sweats
4.
Myalgia
5.
Arthralgia
6.
Chest pain
7.
Fatigue
8.
Extrapulmonary (disseminated blastomycosis) painless
abscess (1 mm diameter or more, as lesion enlarge the
center of the lesion will heal forming “Atrophic scar’, which
would lead to elevated patch more than or equal to 2 cm
wide with an abruptly slopping purplish red abscess scalded
border.)
Culture- tissue & respiratory specimens,
Urinary antigen detection, PCR
decomposing material such as wood, leaves etc.
CLINICAL MANIFESTATIONS
Complement fixation (CF), Lateral flow assay,
TREATMENT:
⎯
⎯
⎯
⎯
Antifungal (Disseminated)
Fluconazole
Amphotericin B
History: It was first found in San Joaquin Valley (California)
May spread via pulmonary or hematogenous route;
inhalation of airborne arthroconidia
Endemic to the US, Mexico, South America, Arizona,
California’s Southern San Joaquin Valley
Usually it may be benign, asymptomatic, self-limiting respiratory
infection
RISK FACTORS:
1.
Immunocompromised
2.
Pregnant
3.
Diabetes Mellitus
4.
Filipino or a person of color
DIAGNOSTIC TESTS
1.
Enzyme immunoassay- wherein we will be able to detect
specific IgM and IgG antibodies
2.
Immunodiffusion- through this we are able to identify IgM
antibodies, which are positive during the early course of infection.
Helpful in detecting infection during its early stage. Not definitive.
3.
Complement fixation (CF)- where you can find IgG
4.
Lateral flow assay
5.
Culture - tissue and respiratory specimens
6.
Urinary antigen detection
7.
Polymerase Chain Reaction (PCR)
CLINICAL MANIFESTATIONS
Page 3 of 7
RTRMF – BSN LEVEL III
MARINURSE AND FRIENDS
NCM 112: MEDICAL-SURGICAL NURSING
LECTURER: MR. ANDRE CARLO DE VEYRA
F#3
1.
Fatigue
DIAGNOSTICS
2.
Cough
1.
Antigen detection in urine and serum
3.
Dyspnea
2.
Antibody test – (2 to 6 weeks after acquiring)
4.
Headache
3.
Culture - (Tissue, Blood, Body Fluids. It takes 6 weeks to
5.
Night sweats
6.
Myalgia
7.
Rash
be positive after acquiring the disease, initially it will not
be positive, the wait for 6 weeks)
4.
Microscopy – (low sensitivity, but can provide quick
diagnosis)
5.
PCR
CLINICAL MANIFESTATIONS
1.
HISTOPLASMOSIS
ALSO KNOWN AS:
---------------------------------------------------------------
CAUSATIVE AGENT:
Histoplasma capsulatum
INCUBATION PERIOD:
3 – 17 days
RESERVOIR:
MODE OF TRANSMISSION:
Soil, heavily contaminated with bird or bat
droppings
Inhalation of airborne microconidia after
disturbance of contaminated material
PERIOD OF COMMUNICABILITY: --------------------------------------------------------------DIAGNOSTICS:
TREATMENT:
Antigen detection in urine and serum;
Antibody test- (2-6 weeks after acquiring);
Culture; Microscopy; PCR
1. Mild to moderate cases – may resolve
without treatment
2. Amphotericin B (severe acute
pulmonary or chronic disseminated
cases, with CNS involvement)
3. Itraconazole (mild to moderate cases or
as step down)
A.
Primary pulmonary – self-limiting
B.
Disseminated – bones, joints, soft tissue and meninges
involvement
COMPLICATIONS
1.
Progressive, chronic, or disseminated disease
2.
Meningitis
3.
Diffuse lung disease- HIV patients
-
People who developed Coccidiomycosis might develop immunity after
Acute pulmonary histoplasmosis
a.
Fever
b.
Malaise
c.
Cough
d.
Headache
e.
Chest pain
f.
Chills
g.
Myalgia
⎯ Patients with history of pulmonary disease are at risk for
Chronic Histoplasmosis and that may lead to Disseminated
Histoplasmosis – which involve already other parts of the body
COMPLICATIONS
1.
Pericarditis
2.
Broncholithiasis
3.
Pulmonary nodules
4.
Mediastinal granuloma
5.
Mediastinal fibrosis
-
Those with history of pulmonary disease may develop
pulmonary or disseminated histoplasmosis
TREATMENT
1.
Mild to moderate cases – may resolve without treatment
2.
Amphotericin B (severe acute pulmonary or chronic
disseminated cases, with CNS involvement)
3.
Itraconazole (mild to moderate cases or as step down)
(Step Down meaning tapos na sya sa Amphotericin B
then we want to continue the treatment for a longer
period of time, then we will step down from
infection.
Amphotericin B to Itraconazole)
MUCORMYCOSIS
ALSO KNOWN AS:
Previously called Zygomycosis
Molds belonging to the order Mucorales
CAUSATIVE AGENT:
Rhizopus species. mucor species
Cunninghamella bertholletiae,
Apophysomyces
INCUBATION PERIOD:
3 – 17 days
RESERVOIR:
Soil
MODE OF TRANSMISSION:
PERIOD OF COMMUNICABILITY:
⎯ Inhaled, then got into the lungs and travels to the lymph.
DIAGNOSTICS:
HIV
2.
Organ transplant
3.
Immunosuppression
4.
Infants
5.
More than 55 years old
from the Environment
--------------------------------------------------------------Histopathological
evidence
culture
specimen
from
a
or
positive
culture
of
nonsterile sites (sputum) – DEFINITIVE
RISK FACTORS
1.
Inhalation, Inoculation, Ingestion of Spores
TREATMENT:
1. Amphotericin B - first line treatment
2. Posaconazole, isavunconaxole
3. Surgical debridement or resection of
infected tissue
Page 4 of 7
RTRMF – BSN LEVEL III
MARINURSE AND FRIENDS
NCM 112: MEDICAL-SURGICAL NURSING
LECTURER: MR. ANDRE CARLO DE VEYRA
HEALTH CARE RELATED OUTBREAKS
⎯ From Adhesive Bandage,
b.
wooden
F#3
Secondary
tongue depressors,
⎯
Pathogen spread hematogenously
hospital linens, negative pressure rooms, water leaks, poor
⎯
Lesions are erythematous, indurated, painful
air filtration, non-sterile medical devices
cellulitis, then progress to an ulcer covered with
black eschar
COMMUNITY ONSET OUTBREAKS
4.
⎯ Trauma associated with Natural Disasters (meaning after bagyo,
hurricane, etc. then this may erupt)
GI Mucormycosis
⎯
Less common
⎯
Non-specific abdominal pain, distention, nausea and
vomiting, GI bleeding
RISK FACTORS
⎯
It is common on patients who are malnourished and
1.
Uncontrolled DM
2.
Malignancy
3.
Organ or hematopoietic transplant
4.
Prolong corticosteroid therapy
5.
Skin trauma
6.
IV drug use
7.
Malnourishment
Pulmonary
8.
Premature and LBW infants
mucormycosis, then may proceed to Disseminated
premature infants. Affected parts are the stomach,
colon, and most of all the ileum is the most affected
5.
Disseminated
⎯
Common in neutropenic patients with
pulmonary
infection
⎯
It may start first as Rhinocerebral Mucormycosis,
Mucormycosis
or
any
forms
of
Mucormycosis
CLINICAL FORMS
1.
⎯
Rhinocerebral mucormycosis
⎯
Common site of spread:
a.
Brain
renal
b.
Spleen
patients,
c.
Heart
hematopoietic stem cell transplant or solid organ
d.
Skin
Most common
transplant,
form in
pts.
neutropenic
with
cancer
DM,
transplant recipient
a.
Unilateral swelling
b.
Headaches
c.
Nasal or sinus congestion/pain
d.
Serosanguinous nasal discharge
e.
Fever
f.
Ptosis, loss of EOM function
g.
Vision disturbance
h.
Necrotic black lesions on hard palate, nasal
turbinates
i.
2.
Drainage of black pus from eyes
Pulmonary mucormycosis
⎯
Common in patients with hematologic malignancy or
profound neutropenia
a.
Fever
b.
Cough
c.
Chest pain
d.
Dyspnea
e.
Angioinvasion
(Refer to Picture above)
❖ LUQ of the Picture – Necrotic Black Lesions of the Hard Palate
❖ RUQ of the Picture – Rhinocerebral Mucormycosis affecting the
Nasal Turbinates
PREVENTION
1.
Avoid areas with a lot of dust (construction, excavation
sites)
2.
Avoid direct contact with water damaged building and
flood water
3.
Avoid activities that involve close contact to soil or dust
NORCADOSIS
ALSO KNOWN AS:
CAUSATIVE AGENT:
3.
Primary
⎯
Direct inoculation of fungus to disrupted skin
⎯
Acute inflammatory response with pus, abscess
Nocardia nova, N. farcinica,
N. cyrincigeorgica, N. brasiliensis
INCUBATION PERIOD:
------------------------------------------------------------
RESERVOIR:
------------------------------------------------------------
MODE OF TRANSMISSION:
------------------------------------------------------------
PERIOD OF COMMUNICABILITY:
------------------------------------------------------------
DIAGNOSTICS:
------------------------------------------------------------
TREATMENT:
1. Antimicrobial Susceptibility Testing (AST)
should be performed.
2. N. Farcinica – resistant to multiple
antimicrobial agents including TrimethoprimSulfamethoxazole (TMP-SMX)
3. Abscess – Surgically drained
Cutaneous mucormycosis
a.
------------------------------------------------------------
formation, tissue swelling, necrosis, lesions
Page 5 of 7
RTRMF – BSN LEVEL III
MARINURSE AND FRIENDS
NCM 112: MEDICAL-SURGICAL NURSING
LECTURER: MR. ANDRE CARLO DE VEYRA
⎯
Routine culture must be held for at least 14 days tissue
F#3
MANIFESTATIONS:
samples from lungs, mucus from lower airways, skin, brain
Pneumonia-like illness – cough, fever, chest pain, weight loss
tissues
COMPLICATIONS:
1.
Meningoencephalitis
–
fever,
headache,
lethargy,
mental status changes
2.
Permanent neurologic damage
CLINICAL MANIFESTATIONS
⎯
Invasive pulmonary infection
1.
Fever
2.
Cough
3.
Chest pain
4.
Pneumonia
5.
Lung abscesses
6.
Cavitary lesions
⎯
Disseminated infection
⎯
CNS involvement – Brain abscess
1. Headache
Infected meninges: where you can see that there is an infected
cerebral spinal fluid and there are swollen tissues that occupies the
2. Lethargy
space which may lead to your signs and symptoms; your headache,
3. Confusion
fever. And the problem there is upon its healing it may leave
4. Seizures
5. Sudden onset of neurologic deficit
permanent neurologic damage
TREATMENT:
1.
Fluconazole
–
for
asymptomatic,
mild-moderate
pulmonary infections
before it grows out in terms of level, early detection and
-
prompt treatment is important.
Before it reaches the meninges and affects the CNS, you
-
know that the disadvantage there is even if it leads to severe
CNS infection it may lead to permanent neurologic damage.
There may be mental status changes.
PREVENTION:
how do we prevent this from occurring? Boost your immune
-
1.
Wear shoes.
2.
Protect open wounds and cuts.
system.
2.
Amphotericin B – severe pulmonary and CNS infections
CRYPTOCOCCOSIS
ALSO KNOWN AS:
------------------------------------------------------------
CAUSATIVE AGENT:
Cryptococcus neoformans
INCUBATION PERIOD:
-----------------------------------------------------------Soil, decaying wood, tree hollows,
RESERVOIR:
bird droppings
MODE OF TRANSMISSION:
PERIOD OF COMMUNICABILITY:
Inhalation of basidiospores or
desiccated yeast cells
TNIEA VERSOCOLOR
ALSO KNOWN AS:
Pityriasis Versicolor
CAUSATIVE AGENT:
Malassezia (Alapao)
INCUBATION PERIOD:
------------------------------------------------------------
RESERVOIR:
------------------------------------------------------------
MODE OF TRANSMISSION:
------------------------------------------------------------
------------------------------------------------------------
1. Culture
DIAGNOSTICS:
------------------------------------------------------------
3. Antigen detection (CSF or serum)
a. Latex agglutination
1. Selenium sulfide
TREATMENT:
b. Enzyme immunoassay
c. Lateral flow assay
TREATMENT:
yeast cells
PERIOD OF COMMUNICABILITY:
2. Microscopy
DIAGNOSTICS:
Inhalation of basidiospores or desiccated
1. Fluconazole
2. Amphotericin B
RISK FACTORS:
1.
Advanced HIV/AIDS (CD4 count of less than 200 cells/mm)
2.
Organ transplant recipients
3.
Immunosuppressive treatment
⎯
2. Ketoconazole (gel/cream)
3. Itraconazole
4. Fluconazole
the fungus will alter the pigmentation of the skin resulting in discolored
patches
CONTRIBUTING FACTORS:
1.
Hot humid weather
2.
Oily skin
3.
Hormonal changes
4.
Weakened immune system
Page 6 of 7
RTRMF – BSN LEVEL III
MARINURSE AND FRIENDS
NCM 112: MEDICAL-SURGICAL NURSING
LECTURER: MR. ANDRE CARLO DE VEYRA
CLINICAL MANIFESTATION:
1.
F#3
CANDIDIASIS (Moniliasis)
Patches of skin discoloration (back, chest, neck, and
upper arms)
ALSO KNOWN AS:
Moniliasis
CAUSATIVE AGENT:
Candida albicans
2.
Mild itching
INCUBATION PERIOD:
12 hrs – 5 days
3.
Scaling
RESERVOIR:
------------------------------------------------------------
MODE OF TRANSMISSION:
Sexual contact
PERIOD OF COMMUNICABILITY:
-----------------------------------------------------------1. Stool culture
2. Gram
DIAGNOSTICS:
staining
of
skin,
vaginal
discharge, scrapings
1.
Nystatin- for oral thrush
2.
Clitrimazole, fluconazole,
ketoconazole, for mucous
membrane and vaginal infection
TREATMENT:
3.
Fluconazole or amphotericin for
systemic infection
TINEA (Ringworm)
ALSO KNOWN AS:
Ringworm
CAUSATIVE AGENT:
-----------------------------------------------------------
INCUBATION PERIOD:
------------------------------------------------------------
RESERVOIR:
------------------------------------------------------------
MODE OF TRANSMISSION:
Fomites
PERIOD OF COMMUNICABILITY:
------------------------------------------------------------
CLINICAL MANIFESTATIONS:
1. Hx and PE
2. Microscopy – KOH Potassium Hydroxide
DIAGNOSTICS:
Stain
3. UV light (Wood's lamp)
1.
Scaly skin, erythematous & popular rash sometimes
covered with exudates
2.
Nails red, swollen, nailbeds darkened, occasionally purulent
discharge & separation of pruritic nails from nailbeds
3.
Oral thrush - cream or bluish white patches on tongue,
mouth, pharynx (bloody engorgement when scraped)
4.
Retrosternal pain & regurgitation
5.
Vaginal mucosa - white or yellowish discharge with
4. Culture
pruritus, and local excoriation; white or gray raised
1. Tinea pedis (athlete’s foot)
on vaginal walls
-
Antifungal terbinafine
-
Chronic - oral antifungal:
a) terbinafine
b) itraconzole
c) fluconazole
-
TREATMENT:
Adjunctive therapy:
foot powder, talcum powder
2. Tinea capitis
-
Topical antifungal
-
Griseofulvin (DOC)
-
Terbinafine (for px >4 y/o)
-
Selenium sulfide shampoos
COMPLICATIONS:
1.
Renal system: Fever, flank pain, dysuria, hematuria,
Pulmonary system: hemoptysis, fever and cough
2.
Brain: headache, seizure
3.
Endocardium: may lead to systolic/ diastolic murmur, fever,
chest pain.
4.
Eye: Blurred vision, orbital and periorbital pain.
COMPLICATIONS:
1.
Onchomycosis (nails)
2.
Tinea corporis
3.
Tinea pedis
4.
Vaginitis
5.
Aseptic meningitis
Lesion is erythematous, missed, scaly ring with central
6.
Paronychia
clearing
7.
Malabsorption syndrome
2.
Multiple lesions present
8.
Myocarditis
3.
Mild to exudative lesions.
9.
Endocarditis
10.
Granuloma
3. Tinea corporis/cruris
CLINICAL MANIFESTATION:
1.
PREVENTION:
1.
Keep skin clean and dry
2.
Wear shoes that allow air to circulate freely around your feet
3.
Don't walk barefoot on areas like locker room, public showers
4.
Cut fingernails and toenails short
5.
Change socks, underwear at least once a day
6.
Don't share clothing, towel, sheets and other personal items
7.
Wash hands with soap and running water after playing
with pets
8.
Shower after practice session (for athletes)
patches
TREATMENT:
1.
Nystatin- for oral thrush
2.
Clitrimazole, fluconazole, ketoconazole, for mucous
membrane and vaginal infection
3.
Fluconazole or amphotericin for systemic infection
•
Practice universal precaution
•
Apply cream and lotion or oil on pruritic site
•
Advise client not to scrape the oral thrush
•
Check vaginal discharge & note the color, odor and
amount
•
Check high risk patients daily
END
Page 7 of 7