Fungal infection


Perhaps the thought of fungal infection scares many of you. The truth is many types of fungi have chosen our skin and mucous membranes as their habitat. In most cases, the normal co-habitation between fungi and humans does not lead to any issues. In specific circumstances, some of these fungi may change and cause an infection.

 

The most common areas of the human body where fungal infections develop are the skin, the scalp, the feet, the nails of the feet and the hands, the mouth and the vagina. Fungi require warmth and humidity to develop and they flourish on warm and sweaty skin, especially between the toes, the inguinal folds, and the armpits. Fungal infections are transmitted indirectly from human to human by using shared bathrooms, swimming pools, walking barefoot in public areas, using shared cloths and towels, as well as from animals or soils to humans.

There are 2 main types of fungi – Dermatophytes and Candida.

Тrichophyton rubrum is one of the most wide-spread dermatophytes and a main cause of the most common dermatomycoses.

Foot fungus is one the most common fungal infections. However, most often a person is affected not only by foot fungus but also by nail fungus and inguinal folds fungus. This disease is also very common among athletes and in the military.

There are three main clinical forms of foot fungus:

- Intertriginous form which affects the area between the 3rd and the 4th toe and between the 4th and the 5th toe on one foot or both feet. Severe itching is typical for this disease, especially if the feet are warm and sweaty.

- Hyperkeratotic form, which manifests with redness and scaling of the skin, especially in the area of the heels and the foot arch. This form is also known as hyperkeratotic feet. It is often combined with onychomycosis (fungal infection of the nails).

- Dyshidrotic form, where blisters full of fluid are formed. It is also characterised by strong itch.

Onychomycosis is fungal infection that affects the nails of the feet or the hands. It accounts for 30% of all dermatophyte infections. In the beginning, before nail fungi develop, there are fungi on the skin of the feet and/or the hands. Therefore, they should be treated to protect the nails. In general, the nails of the feet are more likely to be affected. Usually, only the edge of the nail plate, mainly on the big toe, is affected initially. The infection progresses gradually and may be transmitted to other nails. Eventually, the nails lose their shine, darken and become off-white or yellow-brown in colour.

Inguinal epidermophytosis is common among drivers and overweight individuals. It starts with one or several red spots in the area of the inguinal folds or on the inside of the hips. Spots grow gradually, becoming pale in the middle, while the edge is slightly raised, reddish and scaly. Strong itch is present, especially during sweating and warming.

The so-called dermatomycosis of smooth skin are similar in appearance. Round or oval individual or rarely multiple spots occur which grow in size at a different rate. Usually the edge of lesions is active, while they gradually become pale in the middle.

Candidosis is also known as thrush or соор. Candidosis affects areas with increased humidity. It is estimated that each person suffers from Candida infection at least once during his/her lifetime.

Candida albicans is the most common cause of Candidosis. Interestingly, Candida albicans is often a component of the normal oral or gastrointestinal flora, as well as of the body orifices.

Candidosis is more common among people who suffer from impaired and suppressed immunity or in the presence of concomitant diseases (diabetes mellitus, atopic dermatitis, AIDS). Obesity, prolonged stay in bed, the area under the diaper in babies, areas of loose dentures and pregnancy create favourable conditions for its development. 

Other risk factors for Candidosis include the use of some medications: oral contraceptives (birth control medications), systemic antibiotics and corticosteroids.

Candida infection may affect different areas and, therefore, it may progress differently, depending on the body area.  

Candidal intertrigo affects mainly folds and areas with increased friction (armpits, genital area, under the breasts in women). The disease manifests with redness, ulceration and moistening of the affected area. White or yellowish coating may occur at the basis of the folds. Scaling and small pustules are also possible. Complaints include discomfort, burning, itching and pain.

 Diaper dermatitis is also known as diaper rash. This condition is typical for breast-fed children and occurs in the areas under the diaper.

It is caused by skin irritation due to urine, excrements, retention of foam from detergents and, more rarely, change of diaper. All these factors lead to warm and wet environment. Candida from the excrements may cause secondary infection.

Oral thrush (oral candidiasis) is characterised by multiple white coatings located on the surface of the oral mucous membrane, buccal mucous membrane, on the soft palate and the hard palate, on the tongue, the gums, and on the pharynx.

Angular cheilitis is also known as perlèche. It manifests with redness and chapping in the corners of the mouth. It is observed more often in children and in people who release secretions from the mouth following a stroke or due to loose dentures. It very often combines with Candida infection inside the oral cavity.

Paronychia acute or chronic inflammation of the nails characterised by redness, swelling, and increased tenderness of the fingernail folds, as well as pus-like secretion.

Candidal vulvovaginitis manifests with itching, redness and white secretion (the so-called leucorrhoea). Besides the vagina, it may also affect the labia minora and labia majora, and even the internal surface of the hips. It is estimated that almost every woman suffers from genital candidiasis at least once during her lifetime. Furthermore, genital candidiasis is observed in 25% to 33% of the pregnant women.

Candidal balanitis and Candidal balanoposthitis is more common in adult men who are not circumcised. The disease involves the occurrence of small red pustules, blisters, or even lesions (ulceration) of the head of the penis.

The first step to diagnosing a fungal infection is medical examination. An experienced specialist can diagnose it even based on appearance. In addition, different examinations could be performed to confirm or discard the diagnosis:

- A Wood's lamp examination;

- Microscope examination of a native preparation;

- Testing a culture to detect fungi.

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