Fungal Infections

September 25, 2009

Causes and Symptoms of Ringworm

Filed under: fungal infections, Health, skin fungal infection — patoconnor @ 10:56 am

Ringworm

Ringworm

Causes and Symptoms of Ringworm
Posted by Bin Du | 16 September 2009, 7:29 am

Ringworm is a skin condition that is far more common than many understand. Luckily, because of its common occurrence, ringworm can be quite easy to identify and treat if one knows what to look for.

The condition’s name, “Ringworm”, is quite misleading. The tell-tale rings of red or flaking patches of skin are actually not caused by a worm at all. Ringworm, formally known as Tinea, is actually caused by a microscopic skin fungus that is related very closely to the fungi that cause athlete’s foot and jock itch. These fungi feed off of skin cells and as they multiply and move on to new skin they produce an itchy and sometimes painful series of rings on the skin.

Identifying ringworm can be quite easy. When looking closely at ringworms, you will notice that the affected area will have a circular or oblong shape. The innermost section of the skin infection will have normal color and texture while the outer “ring” will appear to be red, dry or flakey. The irritated outer edge may appear as a thin line of peeling dead skin, or may look like a thick band of red rash.

The cause of the uniquely round shape of a ringworm infection is the way that the ringworm fungus grows. It begins in a tiny centralized point on the skin, and as the fungus feeds on skin cells it moves outwards towards new territory. The origination point eventually heals itself, and the fungi continue on their outward direction leaving a normal patch of skin in the center of a ring of irritated skin.

As with both jock itch and athlete’s foot, ringworm is contagious. The ringworm infection can be spread through both person to person and person to animal contact. It is most commonly contracted through the sharing of personal items (combs, clothing, etc.) or through direct skin to skin contact (i.e. petting a dog or cat). Fortunately, once ringworms receive treatment and the rash begins to fade they are no longer contagious.

Once you have identified ringworm, begin treating with an over-the-counter antifungal cream. Although there are ringworm-specific ointments, athlete’s foot and jock-itch creams and sprays are also effective at treating ringworm as they are all a member of the same fungi family. With treatment ringworm will fade and clear up within two to four weeks. However, if after administering treatment for two weeks, there is no relief from symptoms or symptoms appear to be worsening you should notify your doctor as the infection may need more aggressive care.

To prevent yourself and others from contracting ringworm, follow the same steps that you would to avoid jock itch and athlete’s foot skin infections. Thorough washing and drying of the skin, nails and scalp are essential for preventing skin infections. Avoid sharing personal items with others and always wear shower shoes and use your own towel when using public showers. Change promptly out of damp or dirty clothing and do not re-wear clothing items until they have been thoroughly washed and dried.

Contact your doctor if you are unsure if your skin infection or rash is ringworm, or if you appear to have numerous skin infections on multiple parts of the body. If proper treatment for skin infection is not received they may worsen and spread, causing great discomfort.

More information on ringworm and other fungal infections can be found at any healthcare website. Two that are easy to use are http://www.medicinenet.com and http://www.webmd.com, although additional information can also be found through your medical insurance carrier site or local health department.

– By Denise Kawaii | AC

Ringworm

zikkar

 

The role of neutrophils in the development and outcome of zygomycosis in haematological patients.

The role of neutrophils in the development and outcome of zygomycosis in haematological patients.

Pagano L, Valentini CG, Fianchi L, Caira M.
Istituto di Ematologia, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, I-00168 Rome, Italy. lpagano@rm.unicatt.it

Zygomycosis constitutes the third leading cause of invasive fungal infections following aspergillosis and candidosis. Patients with haematologic malignancies or haematopoietic stem cell transplantation are particularly susceptible to zygomycosis. Neutropenia represents the most important pathogenic mechanism influencing the onset and outcome of zygomycosis. Neutrophils cause a lesion of the fungal wall with subsequent destruction by macrophages. They also enhance the activity of antifungal drugs against Zygomycetes. Strategies that aim to increase neutrophil count and function, such as granulocyte colony stimulating factor and granulocyte transfusion, could play an important role in the management of this life-threatening infectious complication.

PMID: 19754754 [PubMed – in process]

Zygomycosis and diabetes mellitus.

Zygomycosis and diabetes mellitus.

Clin Microbiol Infect. 2009 Oct;15

Lanternier F, Lortholary O.

Université Paris Descartes, Centre d’Infectiologie Necker-Pasteur, Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants malades, Paris, France.

Zygomycoses are severe angio-invasive fungal infections that develop in immunocompromised and diabetic patients. Any episode of sinusitis not responding to short-term antibacterial therapy should evoke the diagnosis of zygomycosis in the latter population, especially in cases of a surrounding necrotic area. Appropriate diagnosis is obtained after careful direct examination of the sample and culture. Current therapy underscores the need to control glycaemia and acidosis in addition for urgent administration of high-dose liposomal amphotericin B in combination with extensive surgery.

PubMed

Incidence of zygomycosis in transplant recipients.

Incidence of zygomycosis in transplant recipients.

Clin Microbiol Infect. 2009 Oct

Cuenca-Estrella M, Bernal-Martinez L, Isla G, Gomez-Lopez A, Alcazar-Fuoli L, Buitrago MJ.
Servicio de Micología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Ctra Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid, Spain. mcuenca-estrella@isciii.es

Recently, a remarkable increase in the incidence of zygomycosis has been reported from institutions in the USA and Europe. The use of voriconazole for the treatment of aspergillosis and, less frequently, the use of echinocandins as empirical treatment for invasive fungal infections are thought to be responsible for the increase. In addition, an increased incidence of this infection has been observed in transplant recipients, including both haematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT) patients. There are no global surveys on the prevalence or incidence of zygomycosis, but data from individual institutions and countries show that zygomycosis is an emerging infection. The increased incidence of zygomycosis most probably reflects a greater frequency of predisposing factors, such as higher numbers of patients undergoing HSCT and immunosuppressive chemotherapy. In addition, the emergence of rare pathogens as a result of the rise in the use of antifungal therapy against common species can be postulated. Further, the availability of antifungal agents with activity profiles that are more specific for selected fungi increases the necessity of identifying pathogenic fungi; the frequency of Zygomycetes infections may have been underestimated until now because therapeutic decisions did not depend on the precise identification of pathogenic fungi.

PubMed

Outbreaks of zygomycosis in hospitals.

Outbreaks of zygomycosis in hospitals.

Clin Microbiol Infect. 2009 Oct

Antoniadou A.
4th Department of Internal Medicine, Athens University Medical School, University General Hospital ATTIKON, Athens, Greece. ananto@med.uoa.gr

Zygomycosis refers to a group of uncommon and frequently fatal mycoses caused by fungi of the class Zygomycetes, the organisms of which are usually found in decaying organic matter. Disease can be transmitted by the inhalation of spores or by direct inoculation on disrupted skin or mucosa. For rare diseases such as zygomycosis, two or more cases occurring in a short time should be investigated as a probable epidemic. Twelve hospital outbreaks and two pseudoepidemics caused by Zygomycetes have been cited in the English literature. The first epidemic was recorded in 1977 and the last in 2008. Outbreaks have been reported in the USA, the UK and elsewhere in Europe. Cases have included cutaneous, disseminated, pulmonary and rhinocerebral disease. Species identified have included Rhizopus arrhizus, Rhizopus rhizopodiformis, Rhizopus microsporus, Rhizopus spp., Absidia corymbifera and Rhizomucor pusillius. Sources of infection have included Elastoplast adhesive bandage rolls, ventilation systems, wooden tongue depressors, karaya (plant-derived adhesive) ostomy bags, and water damage to a linen store and patient shower room. Patients have included cardiosurgery patients, renal transplant recipients, orthopaedic patients, adult leukaemia patients, intensive care unit neonates, immunocompromised haematology patients, and burn unit patients. Although zygomycosis outbreaks in the hospital environment are infrequent, a high index of suspicion should exist if necrotic lesions appear in proximity to a postoperative wound. Direct tissue examination and tissue culture and histopathology must be routinely performed.

PubMed

Hyperbaric oxygen therapy and other adjunctive treatments for zygomycosis.

Hyperbaric oxygen therapy and other adjunctive treatments for zygomycosis.

Clin Microbiol Infect. 2009 Oct.

Tragiannidis A, Groll AH.
Second Department of Paediatrics, Aristotle University, AHEPA Hospital, Thessaloniki, Greece. atriagia@auth.gr.

Zygomycetes are increasingly reported as a cause of life-threatening invasive fungal infections in profoundly immunocompromised patients and in those with diabetic ketoacidosis. Zygomycosis, typically presents as soft tissue, rhino-orbitocerebral, pulmonary or disseminated disease and is characterized by rapid clinical progression and high mortality rates. Treatment with amphotericin B lipid formulations in combination with surgery and, perhaps, the addition of caspofungin offers the best chance for survival; posaconazole, a new antifungal triazole, is increasingly used for consolidation or maintenance therapy. Because of the poor prognosis of zygomycosis, particularly in immunocompromised cancer patients, adjunctive treatments such as hyperbaric oxygen therapy, use of immunomodulatory cytokines, and in vivo iron starvation continue to be explored. However, although each of these modalities is based on a plausible scientific rationale and has been helpful in the management of individual patients, there is no clinical evidence for their general effectiveness as adjunctive treatments in patients with zygomycosis. Further experimental and clinical investigations are necessary to determine whether and how these treatments can impact on outcome and to determine which patients and which types of infection may benefit from them.

PubMed

September 17, 2009

Clinical presentation of zygomycosis.

Clinical presentation of zygomycosis.

Clin Microbiol Infect. 2009 Oct

Mantadakis E, Samonis G.

Department of Paediatrics, Democritus University of Thrace and General District Hospital of Alexandroupolis, Thrace, Greece.

Zygomycetes are filamentous fungi with a worldwide distribution. This class of fungi encompasses two orders, i.e. the Mucorales and the Entomophthorales. Members of the latter are associated with chronic cutaneous and subcutaneous infections that are limited to the tropics and rarely disseminate to internal organs. The order Mucorales includes several species involved in rhinocerebral, pulmonary, cutaneous, gastrointestinal and other less frequent infections in immunocompetent and immunocompromised individuals, and is characterized by a tendency to disseminate. Portals of entry of zygomycetes are usually the lungs, skin, and gastrointestinal tract. A characteristic property of zygomycetes is their tendency to invade blood vessels and to cause thrombosis-processes that result in subsequent necrosis of involved tissues. Risk factors associated with zygomycosis include prolonged neutropenia and use of corticosteroids, solid organ or haematopoietic stem cell transplantation, AIDS, poorly controlled diabetes mellitus, iron chelation with deferoxamine, burns, wounds, malnutrition, extremes of age, and intravenous drug abuse. Recently, the widespread use of voriconazole for prophylaxis or treatment of aspergillosis in patients with haematological malignancies has been linked with a rise in the numbers of cases of invasive zygomycosis. As the symptoms, clinical signs and imaging findings of these infections are non-specific, a high index of suspicion is required for timely diagnosis. Early diagnosis, correction of the underlying predisposing factors, aggressive surgical debridement of all infected tissues and lengthy administration of antifungals are the only potentially curative options for this rare but emerging invasive fungal infection.

PubMed                                      

 

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