Dr. Rachna Pande
Fungi are one of the infectious agents that can infect the body. They can affect any external or internal part of the body. The visible and common manifestations is itchy toes, smelly feet, scaling of palms, e.t.c. Spores of fungi are like seeds of plants and are present in the atmosphere and over damp surfaces. They can enter the body through any possible route.
Athlete’s foot is fungal infection of the sole or toes. It can occur due to walking about bare footed and exposed to dampness, as in swimming pools and sauna baths. Wearing socks damp with sweat for long hours makes one susceptible to athlete’s foot. There is intense intermittent itching and or white discoloration on sole or between toes. Untreated, slowly it spreads to other toes causing aggravation of symptoms. Scalp can be affected by fungus during hair cut due to contaminated scissors being used from one client to another.
Superficial fungal infection can be anywhere on the skin but moist areas like axilla, breasts, groin, genital parts are more prone due to dampness. There is white or light colored discolored rashes which tend to flake off. These flakes disperse spores in the environment tending to infect other people. In otherwise healthy persons these infections are usually localized. But in immune depressed people like HIV/AIDS patients there is extensive infection involving entire skin.
Fungal infections involving the nails cause black discoloration of the nails which is otherwise symptom free. Mouth may be involved internally leading to painful swallowing and talking.
If the ear is affected there is intense itching inside or outside the ear, depending on the site affected. Scratching results in secondary bacterial infections. Thus pain and purulent secretions are added to the already existing problem.
Fungal spores can enter lungs through nose and produce features similar to pneumonia and tuberculosis. Heart failure can be produced due to involvement of the layers of the heart. Esophageal or pharyngeal involvement leads to painful swallowing. Fungal infections of the internal organs usually occur in immune depressed states where body’s immunity goes down as in persons with HIV/AIDS, chronic renal failure, diabetes, e.t.c. The brain substance and covers (meninges) can be affected by various kinds of fungal infections causing loss of consciousness, paralysis, convulsions, e.t.c. problems.
Prolonged antibiotic or corticosteroid use can lead to fungal infections, due to depressed immunity. Fungal infection of the visible parts of the body like skin, mouth, genitals, e.t.c. is easy to diagnose due to its characteristic appearance. Diagnosis is confirmed by examination of the smear from affected part under the microscope. Difficulty comes in diagnosing the infection of the internal body parts because it mimics many other diseases. It needs a high degree of suspicion. Signs of presence of fungus anywhere on the body give a clue to the nature of infection in such cases.
These infections are entirely preventable. One should always keep the body parts clean and dry, because moisture predisposes to these infections. Underwear and socks of synthetic material should be shunned and replaced by cotton material because nylon does not allow skin to, “ breathe”.
If one has been infected already for long or repeatedly, a prolonged treatment is needed to eradicate the infection. For example infection of under arms or genitals would need 4 to 6 weeks of treatment whereas that of nails would require about 9 months.
Antifungal tablets, ointments and dusting powders available for eradicating the infection. A person has to follow his physician’s decision regarding the mode of treatment to be taken. A word of caution, whatever treatment taken will clear the present problem but if precautions are not take, re infection can occur easily in susceptible conditions.
Dr. Rachna Pande
Specialist internal medicine
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