fungal diseases

introduction

Fungal diseases are among the infectious diseases and represent in addition to the bacterial and viral infections, a third major group of infectious diseases. The doctor uses for fungal diseases, the term mycosis (Greek: mykes - the fungus ). Of course, not all of the many thousands of fungi we know are dangerous to humans, but around 180 species can trigger disease-related illnesses.

From a medical point of view, a rough classification of fungi in filamentous fungi ( dermatophytes ), yeasts and molds makes sense. The fungi pathogen group differs in some important characteristics from other pathogens such as bacteria or viruses, so diagnostics and treatment options must be tailored to different fungal diseases.

The appearance of fungal diseases is subject to a wide spectrum. The most common fungal diseases are superficial and found on the skin or nails. They are called tinea . This includes, for example, the annoying but harmless athlete's foot. In addition to these superficial mycoses, there are also systemic infections affecting the whole body and internal organs. These can be life-threatening, but occur almost exclusively in seriously ill and debilitated people based on other underlying diseases.

symptoms

The exact manifestation of the symptoms depends on the pathogen and clinical picture. The most common symptom of superficial fungal diseases is skin lesions. They are usually noticeable as round, but also patchy diffuse redness. The skin starts to dandruff. Depending on the severity, a yellowish-white secretion appears. In addition, those affected complain about a severe itching, which further promotes the spread of the fungus.

In hairy areas hair falls out, mucous membranes can show white deposits. Deeper fungal infections destroy the skin. When systemic mycoses are involved, symptoms of serious illnesses such as fever, shortness of breath, unconsciousness and even death occur.

reason

nail fungus

Fungal diseases are caused by a number of different circumstances. What they all have in common is that the fungus must be able to enter the body or the skin in some form and multiply there. The transmission is usually done by direct contact from person to person, it can also be done indirectly.

The classic example of this is the athlete's foot, which has been taken in the swimming pool. The fungi, or their spores, reach the skin and can nest there in the smallest skin folds or cracks and multiply. If the pathogen gets in contact with a blood vessel, systemic infections can develop. After some time, the typical symptoms of fungal diseases then appear.

There are a number of risk factors that favor the development of a superficial fungal disease. This includes all circumstances that impair the barrier function of the skin or disrupt the immune system in its normal function. Typically, diabetes mellitus or peripheral arterial occlusive disease ( paVk ) are referred to as negative influencing factors. In the course of diabetes, there are sensory disturbances, so that small lesions on the foot may not be noticed. Due to the reduced circulation in the paVk, the skin is no longer completely able to repair small damage to the skin immediately, so that fungi can penetrate more easily.

Also the own personal hygiene is a significant factor in the development of fungal diseases. For example, lack of hygiene can promote fungal infections, and on the other hand, fungal skin diseases are just as common in people with excessive hygiene behavior. The skin naturally has a natural protective coating that creates a slightly acidic environment. If this is attacked by constant washing, this makes it easier for the pathogens to penetrate the skin.

In part, fungal infections are also transmitted via the air by a person inhaling outgrowing spores. An example of this is aspergillosis, which does not occur in healthy people. The most severe fungal infections occur in people with a weakened immune system. Here, the body can no longer fight the infection, so that deep tissues and organs are affected.

diagnostics

Diagnosis determines the type of therapy. Initially, the appearance of redness, scaling and spreading gives important indications in the direction of fungal diseases. In order to identify the pathogen, samples of skin, hair or secretions are taken, which can then be examined under a microscope or grown on certain nutrient media. This allows you to choose a specific remedy for the fungus. It may be necessary to further investigate systemic mycoses.

Athlete's foot and nail fungus

The athlete's foot, Latin tinea pedis, is when a fungus spreads in the toe spaces, on the sole or the back of the foot. A nail fungus, Tinea unguium, affects toenails, but can spread further in the course. They are among the most common fungal diseases and are annoying in most cases, but harmless.

causes

These fungal diseases are usually caused by filamentous fungi that reach the skin via direct or indirect transfer. Especially in public places such as swimming pools or saunas, where people are mostly barefoot, the risk of infection is greatest. Here, the soil, fallen dander and the like may be occupied by the fungus and thus reach the skin of the next patient. About small cracks, the fungus penetrates into the skin and can grow there. Risk factors such as diabetes, overweight and lack of hygiene awareness promote the development of athlete's foot.

symptoms

The classic signs of athlete's foot, as they occur in many fungal diseases, include a pronounced itching, which increases in the course, and reddened skin. If the disease is not treated, the skin begins to dandruff, sometimes small bubbles form. The symptoms develop slowly at first, but then relatively quickly become an impairment. The nail fungus makes itself felt for a long time only on the nail. It turns yellowish-brownish and begins to become brittle and cracked. Also, white stripes can be visible. The thickness of the nail substance increases slowly. During the process, the adjacent nail bed also becomes inflamed and spreading to the rest of the foot is possible.

diagnosis

The diagnosis of these types of fungal diseases is relatively simple. On the one hand you have the symptoms typical of fungal diseases, such as redness, itching and damage to the skin or nail. On the other side the mushroom certificate is available. A skin or nail sample can be examined under a microscope, and a sample of the affected area is taken and allowed to grow in a laboratory so that the exact pathogen can be determined. The accuracy of the diagnosis significantly determines the therapeutic success of fungal diseases.

therapy

The therapy of fungal diseases, including the treatment of athlete's foot or nail fungus, takes place with antimycotics, which act specifically against fungi. These are applied externally or from the inside out as tablets. Against athlete's foot in most cases a superficial treatment with ointments, creams or sprays, which are applied several times a day to the affected areas.

Contained active ingredients include terbinafine, miconazole or bifonazole, which work well against filamentous fungi. The treatment lasts 10 days to several weeks, depending on the course. If the fungus has penetrated deeper layers of the skin, oral antifungals must be prescribed. Nail fungus can be treated with special nail polishes. This may be supplemented by an ointment, which softens the nail so as to reach deeper layers. Rarely does one have to treat systemically with medication. The treatment of nail fungus takes 3 to 6 months, because the nail must first regrow healthy.

genital fungal

A genital fungus is a form of fungal disease that is limited to the penis or vagina. Women are more affected than men.

reason

In genital fungi in men and women, the causative agent in most cases is Candida albicans, a yeast fungus that is particularly sensitive to mucous membranes.
The cause of the woman is usually a disturbed equilibrium of the vaginal milieu, which is not sour enough to keep the pathogen also found in healthy people in check.
Stress, previous inflammations or infections as well as pregnancy and the pill increase the risk of getting fungal infections in the genital area. Frequent washing with aggressive agents also damages the vaginal flora.

In men, a disturbed skin flora, which is also influenced by drugs such as antibiotics or a weakened immune system, a risk factor. Unprotected sexual intercourse increases the risk, especially if the sexual partners often change, since a direct transfer can take place here.

symptoms

Symptoms include intense itching, burning and reddish, possibly flaky lesions, often associated with white-yellowish secretions.

diagnosis

Due to the typical skin symptoms and information provided by patients, it is easy to think of a type of fungal disease. This is confirmed by a smear or a sample of skin or mucus under the microscope.

therapy

The therapy consists in the administration of antifungals, which are used against many fungal diseases. As an ointment or cream, they must be used consistently for several days. The symptoms then disappear after 1-2 weeks, in which sexual intercourse should be avoided.

Fungal diseases on the body and head

Fungal diseases can also occur on the rest of the body, especially between skin folds. The hairy scalp is often the site of a fungal infection, but much rarer than the foot or toenail.

causes

These fungal diseases are also usually caused by filamentous fungi, which are limited to the infestation of skin, hair and nails. Due to their special metabolism, they can not infect mucous membranes. The cause of an infection is the transmission of fungi via infested objects, humans or animals. So combs or clothing, areas in the bathroom and sick people can be directly source of infection. The mushrooms penetrate into the smallest cracks of the skin and spread. People with additional risk factors are more prone to infection than others. These include diabetics and patients with circulatory disorders or general immunodeficiency. Even older people are more prone to fungal infections than younger ones. Improper hygiene measures can make it easier for the fungus to settle in the skin.

symptoms

The symptoms of this form of fungal disease are mainly typical skin lesions. The skin has local, round reddening, in the course of which leads to the formation of white scales. In the center of the redness, the skin is usually lighter and surrounded by a red wall. There is also a significant itching on the affected area. On hairy skin hair fall or be damaged, the doctor speaks of the phenomenon of the mown meadow.

diagnosis

Above all, the typical visible finding leads to the diagnosis. If the patient also reports itching, the diagnosis is made. Furthermore, as with all fungal diseases, skin or hair samples are taken which are further examined under the microscope and in the laboratory. Thus, the exact type of fungus can be identified and a targeted therapy initiated.

therapy

The therapy consists in the application of antifungal agents and depends on the extent of the symptoms. Simple superficial fungal diseases are treated locally with ointments or creams containing terbinafine or miconazole . In severe cases, systemic, oral medication is needed. Fungal attack of the head is always treated locally and systemically. For the itching, cortisone-containing ointments can be prescribed. The therapy of fungal diseases is tedious and requires patience, but is successful in most cases.

Fungal diseases in the mouth

Oral fungal infections are infections of the oral cavity and the pharyngeal region, which in most cases is caused by a certain fungus species called Candida albicans.
This is a yeast fungus that is also present in many healthy mouth and throat, but does not trigger an infection. In people who are sick or have a very weakened immune system, the yeast fungus leads to infections of the oral mucosa. This manifests itself in the form of strongly reddened and inflamed mucous membranes, on which a whitish, detachable coating is formed.

  • Yeast fungi in the intestine
  • Yeast in the mouth

Fungal diseases of the skin

The various types of fungal skin diseases are summarized in medical terminology under the term dermatomycoses.
The infectious fungi are transmitted by human body contact or by contaminated with the fungi objects in everyday life.

Fungi that cause fungal skin disease in most cases include molds, yeasts and so-called dermatophytes.
Depending on the type of fungus and the affected skin, where he settles, there are different types of skin fungus. The most common fungal disease of the skin is the athlete's foot, which is caused by dermatophytes and mainly affects the skin of the toe gaps.
Other forms are fungal diseases on hairy skin and on the head, in the groin and on the hands. A fungal disease of the skin is characterized by a strong, newly occurring itching, which may be accompanied by redness and scaling of the affected skin.
Since most symptoms of a fungus can not be clearly differentiated from an allergic reaction or a skin irritation, one should seek the advice of a dermatologist. Proof of the infectious agent should be provided to tailor the therapy to the specific fungal species. Therapeutically, antimycotics are used in the form of salves, which attack and kill the fungus and also have a nourishing component for the affected skin.

Systemic fungal diseases

This most severe type of fungal disease rarely occurs, but is a serious illness and requires intensive treatment.

causes

Whole body fungal infections occur almost exclusively in patients who have a severely compromised immune system. This can be caused by diseases such as AIDS or leukemia. As a side effect of cancer therapy with cytostatics, the immune system is weakened. In addition, organ transplanters also have an increased risk of getting systemic fungal infections, since the immune system is suppressed by medication in order to prevent organ rejection.

symptoms

The symptoms here are rather unspecific and depend strongly on the organ involvement of the fungus. Systemic mycosis often begins insidiously. There may be shortness of breath, cardiac arrhythmia, nausea, vomiting, and general fatigue. Often also visible on the skin reactions.

diagnosis

The diagnosis is made in addition to the history, a blood sample and the physical examination by sampling the affected regions. As a result, the exact exciter can be detected.

therapy

Therapy is usually stationary by means of high-dose antimycotics. Venous administration is usually required. In addition, symptom control is of great importance.

therapy

Nail fungus varnish

The decisive pillar of therapy for fungal diseases are the so-called antimycotics, a remedy that only works against fungi. In doing so, one makes use of the special structure and metabolism of the mushrooms. One mechanism is the inhibition of cell wall synthesis, so that the fungus can not grow, other substances settle in the cell wall of fungi and destroy them.

Antimycotics are low in side effects, as the attacked structures do not occur in the human body. They are given in the form of ointments, creams, sprays or nail polish to be able to work locally. More severe courses, especially the systemic fungal diseases, require oral therapy in tablet form or parenterally as an infusion. Supportive measures against fungal diseases are hygiene measures such as frequent changes of clothing or bed covers as well as the reduction of the risk factors mentioned above.

The following is a closer look at the most common fungal diseases in terms of cause, diagnosis, symptoms and therapy.

forecast

The prognosis for fungal diseases is extremely positive in most cases. Although it can often take some time for the symptoms to disappear completely, permanent damage is rarely to be expected for nail fungus or athlete's foot as well as other superficial fungal diseases. However, therapy should be initiated quickly to prevent its spread to deeper tissues.

The prognosis of a systemic fungal disease is rather poor. Since the immune system is damaged, the body can hardly fight against the fungus. The prognosis is of course dependent on the particular patient and the corresponding manifestation of the mycosis.

prophylaxis

To prevent fungal diseases often help simple measures. Good, but not exorbitant, hygiene plays an important role. Also, you should pay attention to neat nails. Shoes and socks should not be worn all day long to allow the foot to breathe. In the pool help flip-flops to prevent athlete's foot.

In addition, it always makes sense to minimize its risk factors. This includes a well-adjusted diabetes mellitus and a healthy diet. Genital fungus can be effectively protected with condoms and not too often changing sexual partners. Despite all measures, however, fungal diseases can not always be avoided. Preventing systemic mycosis is difficult because the weakened immune system is the cause of the serious infection. It makes sense here to avoid contact with people who suffer from a fungal disease. A good therapy of the underlying disease is essential here.

Fungal Disease Awareness: Think Fungus! (December 2019).


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