Fungal Infections

February 25, 2012

Several Conditions Mimic Nail Fungus in Children

Several Conditions Mimic Nail Fungus in Children

Feb 2012

By: JEFFREY EISENBERG, Family Practice News Digital Network

As a pediatric dermatologist, Dr. Robert A. Silverman is all too familiar with this scenario: A child is referred to him with a diagnosis of nail fungus, and the parents are frustrated that the oral antifungal agents did not work.

What bothers him the most is not the antifungals, but that the patients didn’t need them to begin with because the child didn’t have a fungal infection, he said at the annual Hawaii Dermatology Seminar, sponsored by Skin Disease Education Foundation (SDEF). Several conditions of the nail in children can easily be mistaken for fungal infections.

Dr. Silverman of the department of pediatrics at Georgetown University Medical Center in Washington discussed how to distinguish fungal disease mimics from other pediatric nail conditions in children.

Onychomycosis, the most common nail infection in adults, is not all that common in children, Dr. Silverman said. Studies have shown the prevalence in children to be less than 3% in developed countries, although it is increased among children who have Down syndrome and HIV, or children from households with moccasintype Trichophyton rubrum. Clinical variants are similar to those that occur in adults, such as white superficial onychomycosis, distal lateral subungual onychomycosis, proximal subungual onychomycosis, and endonyx onychomycosis.

Other conditions that may be mistaken for fungal infections include:

• Psoriasis. Nail findings in patients who have psoriasis can be misinterpreted as fungal disease. Telltale signs of psoriasis in the nails, however, are large, irregular pits and the oil spot sign.

• Subungual tumors. These include subungual exostosis and onychomatricoma. These benign growths push on the skin surface, leading to separation of the nail. “Some people think fungus when it’s really a tumor of the underlying bone,” Dr. Silverman said.

• Pachyonychia congenitaThough often confused with fungal disease, this condition, which involves a single thickened toenail, is somewhat rare. “If someone came in with a thick toenail, I’d culture him or her,” Dr. Silverman said. “If the culture is negative, then you have to start thinking of these other conditions.”

• Alopecia areata. Children may have nail signs of alopecia areata before hair loss occurs. In alopecia areata, the nail surface is studded to near confluence with tiny pits, also known as Scotch plaid nails. Also, the nail will have lost its luster and has a sandpaperlike texture.

“If you see what looks like alopecia areata of the nail, but don’t see any hair findings, you ought to scrape the nail to rule out fungus, because fungus can look like alopecia areata of the nails,” Dr. Silverman said. “And, of course, then you would want to treat it.”

Treatment for fungal infections requires the use of an oral agent for 6-12 weeks, so Dr. Silverman emphasized the importance of obtaining a culture. “If you’re going to treat someone for that length of time, it makes sense to know exactly what you’re treating,” he said.

Also, Dr. Silverman said, any time he sees that a child’s parent appears to have a fungal infection, he considers that to be a red flag when trying to diagnose the patient.




February 13, 2012

Shedding natural light on fungal infections.

Shedding natural light on fungal infections.

Vecchiarelli Ad’Enfert C.


Department of Experimental Medicine and Biochemical Science; Microbiology Section; Perugia, Italy.


Bioluminescence imaging allows the visualization of the temporal and spatial progression of biological phenomena, in particular infection, by non-invasive methods in vivo. This nature-borrowed technology has been successfully used to monitor bacterial infections but recent studies have also succeeded in tracking fungal infections such as those caused by the two major opportunistic fungal pathogens Candida albicans and Aspergillus fumigatus. The findings of Donat and collaborators published in this issue now show that by combining the sensitivity of the Gaussia princeps luciferase with a surface display expression system it is possible to perform longitudinal infection studies on cutaneous forms of aspergillosis with a small number of animals. Besides providing new and valuable information in the field of aspergillosis, the findings of Donat et al. offer a new perspective on the general applicability of bioluminescence methodologies for eukaryotic pathogens where the bacterial lux operon cannot be exploited.

Landis Bioscience

October 29, 2008

Fungus Infections of the Nails

Filed under: Uncategorized — Tags: , , , , , , — patoconnor @ 1:44 pm

Fungus Infections of the Nails

What are fungal infections of the nails?

Fungal infections of the nails are common. The fungus grows in the nail bed, where the nail meets the skin. The fungus grows slowly and does not spread to internal organs. The main concern is the nail discoloration (usually yellow) and change in nail texture and growth. Nails can become crumbly, break easily, and grow irregularly. But because other nail conditions can mimic fungal infection, most doctors will confirm the diagnosis by sending a nail clipping for laboratory evaluation — especially if treatment is being considered.

Fungal infections are not commonly contagious or spread easily between people. The fungus grows in people whose bodies “allow” the fungus to become established without mounting an immune response to suppress the fungus. We know of no ways to boost your immune system to make fungal infections less likely. You may be able to prevent fungus infections by:

Keeping your feet dry, avoiding constant moisture

Avoid non porous, closed shoes made of synthetic materials

Wearing absorbent socks

Wearing water proof sandals when in public showers

What can be done about fungal nail infection?

Because the fungus grows slowly, it is hard to eliminate. The anti fungal medications that eliminate the fungus are strong, must be taken by mouth, and must be taken conscientiously for months in order to be effective. Each drug has potential side effects on other body organs (especially the liver, skin, or bone marrow). To monitor for side effects, periodic blood testing must be obtained, usually monthly, during the time you take the medication. Any symptoms suggesting organ damage should be reported immediately to your physician, such as: unusual fatigue, severe loss of appetite, nausea, yellow eyes, dark urine, pale stool, skin rashes, bleeding, enlarged lymph glands, or signs of infection.

Unfortunately, anti fungal creams applied directly to the nail cannot penetrate the nail bed to kill the fungus at its source, so they are not usually effective.

How effective are the medications at curing the fungus?

The anti fungal medications usually suppress the nail infection when taken as directed. Unfortunately, they cannot guarantee permanent cure. At least 1 in 5 patients (20%) and probably more will have a recurrence of the original nail infection at some time, and re-treatment with medication would be necessary.

Should I take medication to treat my fungal nail infection?

Doctors usually recommend treating fungal nail infections only when such infections cause secondary problems, like pain, recurring ingrown toenails, or secondary bacterial infections of the nails or skin. If the nail infection causes no symptoms, then doctors often will discourage treatment because of the potential side effects, the need to monitor the blood throughout therapy, and the high recurrence rate. Patients with liver or heart disease generally should not take these medications.

Some insurance companies require documentation of secondary problems beyond the mere presence of the fungal infection before they will cover the costs of the anti fungal medications.

April 2002

Acknowledgment and Thanks

Palo Alto Medical Foundation


What is Nail Fungus?

Also known as: Onychomycosis or Tinea Unguium

Nail fungus is made up of tiny organisms (Tinea Unguium) that can infect fingernails and toenails. The nails of our fingers and toes are very effective barriers. This barrier makes it quite difficult for a superficial infection to invade the nail. Once an infection has set up residence however, the same barrier that was so effective in protecting us against infection now works against us, making it difficult to treat the infection.

More than 35 million people in the United States get this fungus. The fungus lives underneath the nail. The nail provides a safe place for the fungus and protects it while it grows, since fungus like dark and damp places. This is why it’s hard to reach and stop nail fungus.

Nail polish and plastic or acrylic nails can trap moisture and fungi. Most often, nail fungus appears in the toenails because socks and shoes keep the toenails dark, warm, and moist. The toenails are 6 to 7 times more likely to be infected than fingernails. Fungi often cause the area around the base (and the sides) of the nail to become red and irritated. At first, the edges or base of the nail is affected. As it spreads, the nail and nail bed show changes. There is often mild discomfort, itchiness, or even pain around the cuticles (flesh surrounding the nails). Bleeding or detachment of the cuticles may occur. The nail can become discolored-yellow-green, dark yellow-brown, and sometimes white spots are seen. The nails thicken and develop abnormal grooves, lines, and tiny punched out holes.

Is it Contagious?

Yes, it can be. The organisms can sometimes spread from one person to another because these critters can live where the air is often moist and people’s feet are bare. This can happen in places like shower stalls, bathrooms, or locker rooms or it can be passed around on a nail file or emery board. So, don’t share them. Nail fungus may also spread from one of your nails to other nails.

How Do You Treat Nail Fungus?

The best treatment of course is prevention. Keep your nails cut straight across. If nails are hard to cut, soften by soaking in salt water (use 1 teaspoon per gallon of water and then dry well). Keep feet dry and well ventilated. Be careful with artificial nails and be selective about choosing your manicurist. Ask about how they sterilize their instruments. See a podiatrist or your health care provider if you see signs of fungus.

Topical creams applied directly to the infected site are often used for less serious infections. Visit the foot care section of your local drug store chain. Creams include Lotrimin, Monistat, Nizoral, Tinactin, and Lamisil. If the topical treatments fail, more potent medications can be taken orally if your health care provider thinks it is necessary. Oral medications may have side effects, so tell your health care provider about any other medications, including birth control like the pill or Depo-Provera, if you are prescribed an oral medication for fungus.

The nails can reveal a lot about the body’s internal health. Healthy nails are often a sign of good health, while bad nails are often a tip off to more serious problems. A high protein diet may help your nails grow stronger and healthier.

Cool Nurse

What is a Fungus?

Filed under: fungal infections — Tags: , , — patoconnor @ 12:56 pm

What is a Fungus?

Introduction to Fungi

Non-Technical Introduction to the World of Fungi and Mycology

Fungi are plant-like organisms that lack chlorophyll. Fungi are one of the five kingdoms of life. Many fungi are good and useful (edible mushrooms would be an example of these) while some cause problems (some fungi can injure plants and people). There are over 100,000 species of fungi. Mycologists are the scientists who study fungus. Medical mycologists study drugs to cure fungal infections, while agricultural and research mycologists study the industrial uses of fungi.Saccharomyces cereviseae is used to make the alcohol in beer. This same fungus is used when we make bread–without its help, we would have flat bread. Without fungi, we would have piles of trash everywhere because fungi get food from our trash. They eat the trash and make it into soil. That is why we do not live in a landfill! For more on this, you might also enjoy Tom Volk’s notes on fungi that are required for a Merry Christmas.Tinea or Dermatomycosis. Ringworm can be found all over the world

Since they do not have chlorophyll, fungi must absorb food from others. Since they don’t use light to make food, fungi can live in damp and dark places. Fungi are supposed to “eat” things when they are dead but sometimes they start eating when the organism is still alive. That is when mycologists come in to figure out what to give to the infected patient or plant to get rid of the fungus.

Good fungus can help with many things to make the world a better place. Out of the many kinds of fungi, the ones we love to eat are mushrooms. We put them on pizza, burgers, salads, and more. During Lent, for those who give up meat, restaurants serve mushroom balls instead of meatballs on spaghetti. Fungi can even make some big things happen in food. For example, a yeast fungus called

Bad fungus is just good fungus trying to do its job way too early to an organism. Most commonly, fungi cause something to happen on the skin of animals or people. This is sometimes called Ringworm, but there is no worm involved! Ringworm can also be called

It mostly forms on the foot and scalp. Some Ringworm is Anthropophilic. Anthropophilic means human (anthro- think of anthropology) loving (-philic), and you catch this fungus from other people. Ringworm can also be Zoophilic or Geophilic. Zoophilic means animal (zoo- just think of going to a real zoo) loving, and this is a fungus you may catch from your pet. Geophilic means earth (geo- as in geology, or the earth) loving, of course you get this one from the soil.allergies. Over 37 million people have allergies and many of them are caused by fungus. Buildings can also get sick. Buildings can get some fungi known as Penicillium and Stachybotrys. They float in the air and can cause watery eyes and breathing problems.Ustilago maydis. Among others are Microbotryum violaceum (formerly known as Ustilago violacea) that infects Caryophyllaceae including Silene species, and Tilletia caries that infects wheat.A discussion from, including a recipe for smut soup!
A discussion of smuts from Tom Volk’s website
A teaching example for the National Association of Biology Teachers

Ringworm is the kind of fungus that gets on the body, but some fungus just irritates the body. Fungus irritates the nose and causes

We also have smut fungi. These fungi live in the soil and are plant parasites. The name “smut” refers to the ripe galls filled with dark sooty spores that are formed when the fungus infests a plant. The most well-known smut fungus is the corn smut,

The growing parts of the corn, including the base of the internodes, the base and the midrib of leaves, and young ears are susceptible to be infected by the smut fungus. Eventually, the fungus produces tumor-like masses on the infected plant which are covered with silvery-white or greenish-white layer. These masses are filled with powdery, darkened spores. These darkened spores, also known as teliospores, are resting spores and help the fungus to resist dry climates and low temperatures. They are either splashed by rain or blown by heavy winds. The teliospores germinate in spring and produce basidiospores which are the actual infective particles.

The smut fungus is not all bad! While it is a remarkable hazard for the farmers, it is consumed as a tasty food in some parts of the world! Smut fungus is sold canned in Mexico and America and is known as “cuitlacoche” or “huitlacoche” in Mexico.

You may also want to visit other websites for more information on smut fungi:


To cure fungal infections, mycologists use a drug from one of these families of drugs: Allylamines, antimetabolites, azoles, glucan synthesis inhibitors, polyenes, and others.Kingdoms of life, and the term fungus refers generically to all members of theKingdom Fungi. There are more than a million species of fungi, but only about 400 cause diseases relevant to man, animals, or plants. These organisms are the subject of this web site. The majority of the pathogenic species are classified within the Phyla Zygomycota, Basidiomycota, Ascomycota, or the form group Fungi Imperfecti. Fungi (the singular form is ‘fungus’), including those pathogenic to humans and animals, are eukaryotic spelled with a ‘u’. While not mutually exclusive, mould spores germinate to produce the branching filaments known as hyphae. Yeasts, on the other hand, are solitary rounded forms that reproduce by making more rounded forms through such mechanisms as budding or fission. For more details on fungal classification, see our discussion of Taxonomy and Nomenclature.

Finally, fungi can be helpful and not helpful, but they all are important and required in life. Fungi are one of the earth’s big recyclers. Without them we could not live, and sometimes humans die because of them, but they are very important and required in life.

(Editorial note: The preceeding section was contributed by a 6th grader who prepared the text as an English class writing assignment. If you or your class prepare fungus-related materials that are suitable for the web and that might be of interest to others, please contact us. We’d love to discuss posting your work!)

Somewhat More Technical Introduction to the Fungi   All living things can be classified into one of five fundamental

Classically, there are two broad groups of fungi: yeasts and moulds. Note that mould

The nuclei of all fungi, like that of other eukaryotic organisms, contains a nucleolus and several chromosomes that are bound by a nuclear membrane. Hyphal cells in septate hyphae may be uninucleate, binucleate, or multinucleate. For the most part, cellular and nuclear division are independent events, especially with respect to vegetative growth. As in other eukaryotic organisms, fungi have mitochondria, 80S ribosomes, and centrioles.

The cell wall of fungi consist of chitin, chitosan, glucan, mannan, other components in various combinations. Fungi are carbon heterotrophs, therefore they require preformed organic compounds as carbon sources. Fungi do not contain chlorophyll.

As an important contrast, the actinomycetes are prokaryotic gram positive filamentous bacteria. Historically, because of their microscopic morphology, some actinomycetes have been studied by medical mycologists. However, they are quite different from fungi. The actinomycetes serve as a host to bacteriophages, whereas fungi cannot serve as their host. These organisms are sensitive to antibacterial agents such as penicillin, but not to antimycotic agents such as amphotericin B, the opposite is true for fungi.

For more information about fungi, mycology, or medical mycology, please consult our:

Dr. Fungus

Welcome to Fungal Infections

Complete guide to fungal infections, types, causes and treatments.  This is a replacement site for my previous blog Fungus Infections.  We will cover information on the types of fungal infections, treatments and prevention.  Also, included will be abstracts and studies for further research.

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