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Anti-fungal
Anti-fungal medicines
What are fungi?
Fungi are microscopic plant organisms that consist of cells, such as mould,
mildews and yeast. They cannot produce their own food; thus they behave as either
parasites or saprophytes, absorbing nutrients from organic matter, such as humans
and animals.
What does this mean to you? Essentially fungi are infections. More commonly
known as moulds and yeasts, fungi are found in nature, and they appear in the
environment (Geophilic), on humans (Anthropophlic), and on animals (Zoophilic).
Moulds have singular hyphae (a threadlike part of the vegetative portion
of a fungus) and produce velvety cotton-looking colonies. Yeasts consist of
a single cell and they reproduce by budding, producing soft pasty-looking colonies.
An example of yeast of which you may be familiar is the Candida species.
Approximately 90 per cent of fungal skin infections are caused by 'dermatophytes',
which are parasitic fungi affecting the skin, hair, or nails.
There are three groups of dermatophytes, called Trichophyton (affects skin,
hair and nails), Microsporum (a type of fungus that causes ringworm epidemics
in children) and Epidermophyton (A fungal which grows on the outer layer of
the skin and is the cause of tinea). These infections are mostly seen after
puberty with the exception of Tinea capitis, which is a fungal infection involving
scalp hair, seen in children.
Dermatophytes also produce what is widely known as 'Ringworm', in which the
fungi limit themselves to dead Keratin, a protein found on the skin.
Fungi that have developed to live on animals can also infect us, and will
usually cause much more inflammation and redness because our immune system sees
them as a foreign invasion and goes into attack.
Other skin infections are caused by yeasts such as Candida. Another known
as Malassezia furfur, or Pityrisporum ovalae, is a type of fungus that causes
brownish patches on the skin This particular yeast resides on skin that has
a high (oily) sebum content such as the face, scalp and chest. It is responsible
for dandruff of the scalp as well as a rash on the body called Tinea versicolor.
Candida can also settle in the moist folds of skin.
Fungal infection of the nails is most common. They crop up in places where
heat, humidity and activities require communal bathing. Seen in approximately
45 per cent of the general population, and in nearly 50 per cent in people over
age 70. Nail infections are rare in children. Toenails are seven times more
likely to be involved than fingernails.
The top ten risk factors are: Communal bathing, Saunas, Spas, Sporting activities,
Closed footwear, Damaged nails by trauma, Conditions changing nails e.g. Psoriasis,
Geneticsusceptibility, Diabetes, Peripheral vascular disease (damage or
dysfunction near the surface of arteries and veins).
What causes nail infections? 50 to 70 per cent nail infections are caused
by Dermatophytes (T rubrum)a parasitic fungus that affects the skin, hair, or
nails; and 5 to 17 per cent nail infections is caused by a fungus called T mentagraphytes.
Less than 5per cent are caused by parasitic fungi, such as Candida and molds.
The vast majority of hair infections occur in children. Look for a mild scaling
of the scalp(dandruff) or a very inflammatory looking (bacterial) abscess. Hair
loss is common and may be permanent.
The degree of inflammation will depend in part on the response of the immune
system, but it will also depend on whether the fungus evolved to be anthropophilic
(on humans) or zoophilic (on animals).
Hair fungus invasion occurs on the hair shaft that the fungus grows. Common
organisms in this type of infection are T. tonsurans, M. canis and M. audouinii.
Typical of T tonsurans is the Endothrix pattern of fungal growth, which is when
the fungal spores grow inside the hair shaft. A 'black dot' pattern evolves,
in which the hairs are broken off at the scalp, leaving bald patches. However,
there may not be much reaction and will show as a very light scale. If the immune
reaction is strong it will appear as a 'Kerion', which is an inflamed mass similar
to an abscess.
The person's lymph nodes may be enlarged in the neck. Watch for persistent
inflammation, which can cause permanent scarring of the scalp, preventing further
hair growth. M. canis produces the Ectothrix pattern (when fungus grows on the
outer surface of the hair) and results in scaly patches with hair loss. Again,
the area can either be localized or generalized on the scalp. As the name, M
canis suggests, this organism normally grows on dogs but also cats and kittens.
This fungus will produce immunofluorecence when examined with a Woods light.
(Immunofluorescence is a laboratory technique to identify specific antibodies
or antigens).
Favus, also termed Tinea favosa, is one of the three primary patterns of
hair infection (ectothrix, endothrix, favus) and is a term to describe the most
aggressive type of scalp hair infection. It is caused by the fungus Trichophyton
schoenleinii. It exists inside the hair shaft and produces air bubbles within
the hair. Yellow thick crusts produce scarring because of the inflammation that
develops.
It is very important to diagnose scalp hair fungal infection in children
as well as those in close contact to clear the infection as well as to prevent
permanent bald patches.
Candidiasis - commonly called yeast infection or thrush - is a fungal infection
of more than 20 species, the most common being Candida albicans. Yeast organisms
are always in our systems, but are usually prevented from multiplying uncontrollably
by naturally occurring microorganisms.
Fungi live on all surfaces of our bodies. Under certain conditions, they
cause infections, particularly in warm and moist areas. Examples are vaginal
yeast infections, thrush, skin and diaper rash, and nailbed infections.
Adults also can have yeast infections around dentures, under the breast and
lower abdomen, and beneath other skin folds. Most of these candidal infections
are superficial and clear up easily with treatment. Rarely the yeast infection
may spread throughout the body, but even common mouth and vaginal yeast infections
can cause critical illness and can be more resistant to normal treatment.
Yeast infections that return may be a sign of more serious diseases such
as diabetes, leukemia, or HIV/AIDS. Fungi can reside in the gut, likely from
the birth canal, but they are not always found in the GI tract. Less than 26%
of individuals will have yeast in their mouths and 18% of the time this is Candida.
Candida is found in 40% of stool samples. This number can increase after
taking antibiotics, and possibly due to diet. 12% of women will have Candida
in the vagina. This is more common in pregnancy and in those on the birth control
pill and using IUD's. The skin is not usually a host to Candida except it is
sometimes seen in the skin folds, particularly in the young and old.
If you are sick, elderly, or very young, you are more prone to getting infection.
Food and debris in the mouth encourage Candida, as seen in Sjogren's disease,
which reduces saliva flow.
Prevention of fungal infections
It's important to understand that although fungal infections are annoying
and can cause some discomfort, you don't need to miss school or work. However,
care should be taken to minimize skin-to-skin contact with others.
What to do about skin, nail or hair infections?
Athletes foot
- Wear flip-flops in changing areas.
- Use antifungal sprays or powders in shoes and feet.
- Dry the feet and between the toes last after a shower to prevent spread
to other parts of the skin.
- Avoid tight or closed footwear especially in warm climates.
- Change socks daily. Cotton socks keep the feet cooler.
- Wash towels daily.
Jock itch (groin infection)
- Wash the groin daily. Dry the skin carefully after bathing.
- Do not dry the feet before the groin to reduce the risk of spreading
fungus from the feet.
- Change underwear daily.
- Wash towels daily.
Ringworm (skin infection)
- Ringworm on the body can either spread from fungus elsewhere on the
skin or from animals. It can also spread from contact with others.
Nail infection
- An infected toenail is common but there won't always be symptoms.
- You may see a thickening of the nail, which can be uncomfortable when
it rubs against footwear.
- You may also see an infection of the skin, especially the web space
between the outer toes.
Scalp infection
- An infection of the scalp would show an increase of fungus.
- It can be spread to others in the same family, or at school.
- There is no need to keep children out of school but combs and head wear
should not be shared with other children.
- There is always a risk of the infection being spread from pets.
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