Of the fungal infections, the most common actinomycosis is most often observed in the respiratory tract. Differentially diagnostic it is necessary to take into account all processes with chronic suppuration, mainly tuberculosis. First of all, the cervical lymph nodes (with the exception of the occipital ones), the lungs, and less commonly the cecum are affected. General symptoms correspond to a chronic purulent infection (the wrong type of temperature, night sweats, leukocytosis, accelerated ROE). They vary with the prevalence of the process. The diagnosis is easily established when there are characteristic actinomycotic friends in the pus.
Since the process is rarely limited only to internal organs , it is almost always possible to get pus. Endocarditis, meningitis, and brain abscesses are rare. The effect of therapy does little to diagnose. The aerobic type of actinomycete is sensitive to sulfonamides, the anaerobic type is sensitive to penicillin.
A rare fungal disease is histoplasmosis , which is rarely diagnosed in the acute stage. It is characterized by a chronic course with uncharacteristic increases in temperature, leukopenia, splenomegaly, enlargement of the liver and lymph nodes, as well as the formation of ulcers on the nasal mucosa, pharynx and digestive tract. In more than half of cases, hypochromic anemia and skin changes are found. The lungs, one might say, are always affected, but foci in the lungs are difficult to recognize in the acute stage. In case of cure, extensive calcifications are found in almost all organs, and especially in the lungs and spleen.
The diagnosis is confirmed by a histoplasmosis test (a skin test with an antigen – histoplasmin from Histoplasma capsulatum). In acute cases, the fungus can be found in the blood, sternal puncture and in the affected areas of the mucosa. The fungus can be grown.
Sporotrichosis , like actinomycosis, is extremely rarely limited to only the lungs. Finding the fungus in the lymph nodes and in the foci of skin lesions, as a rule, facilitates the diagnosis.
Coccidioidomycosis (Coccidioides immitis) is observed mainly in California, rarely in Europe. Of the fungal diseases considered, this is the most contagious. Initially, the respiratory tract is usually affected. The foci are scattered throughout the lungs, caverns are formed, hemoptysis appears. The erythema nodosum encountered in this disease is especially difficult to differentiate from tuberculosis. The disseminated form, accompanied by meningitis, is very rare. The diagnosis is confirmed by skin breakdown and complement binding reaction.
Sortrichosis and aspergillosis (soortrichosis and aspergillosis) do not give a clear picture of the disease. They primarily cause chronic processes in the lungs that can simulate tuberculosis and secondary pneumonia. Aspergillosis is often layered a second time in chronic pulmonary diseases.
Rare fungal diseases are cryptococcosis, geotrichosis and chromoblastomycosis (Cryptococcosis, Geotrichosis and Chromoblastomycosis). In North America and Canada, in obscure cases with darkening in the lungs with simultaneous localization on the skin and bones, one should also remember the possibility of blastomycosis [Blastomycosis (Gi1christ disease)]. The presence of the fungus in sputum, the positive results of the complement binding reaction and skin test confirm the diagnosis.
Fungal diseases as the cause of febrile conditions are increasingly observed recently with prolonged treatment with antibiotics. Innocuous fungi themselves, such as Candida (Monilia) albicans, grow luxuriantly in the body after antibiotics eliminate the rest of the flora. Moniliasis occurs, as a rule, after a febrile period. It is impossible to make a diagnosis only on the basis of the presence of the fungus in excrement: it is necessary at least to exclude other possible causes. Monilia albicans give magnificent growth primarily in the respiratory, intestinal and genitourinary tract. In some cases, fungal sepsis leads to death.
After prolonged antibiotic treatment , abscesses and sepsis caused by thrush are also observed.