Get rid of the fungus – effectively and forever

Skin fungus is a type of skin disease. It is very common, accounting for half of all skin diseases. The skin fungus is not among the dangerous diseases, but people suffering from it experience a lot of inconvenience and discomfort. 

The appearance of the fungus becomes possible when it is affected by dermatophytes and saprophytic infections. At the same time, dermatophytes penetrate and grow in the skin, hair and nails. Skin fungus can occur in any area of ​​the trunk, limbs, head. If it is not treated on the scalp, it can result in hair loss. Therefore, early diagnosis of the disease when referring to a doctor, and its effective treatment are so important . 

Damaged skin becomes a very convenient environment for the defeat of its fungal infections. Getting on the surface of damaged skin, the fungus begins to invade its stratum corneum. The presence of injuries on the skin is a contributing factor. Infection can occur both through household items, and through clothing.

The fungus is by no means a harmless disease, as many are accustomed to consider. So in places where it penetrates the skin, it causes an inflammatory process. And with immunodeficiency, he can wear severe forms. Among the factors that provoke the appearance of fungal diseases, such as: disturbances in the endocrine system. This is possible with diabetes. The lack of vitamins in the body also leads to this. A provoking factor is dysbiosis. Immunodeficiency can trigger many diseases. Including fungus. Increased sweating is also among the adverse factors for skin fungus.

The fungus may show a rash that is red or brown. The area of ​​the skin that is affected by the fungus is clearly limited to a rash. The danger is that the rash present on the body can turn into vesicles filled with fluid. When peeling, small cracks form on the body. And the tissues that are located nearby become edematous. It is especially dangerous when the bacterial flora joins the fungus. In this case, pustules are formed – vesicles with purulent contents. Fungus of the legs, hands, feet is not uncommon. They may be affected by the head, there are fungal diseases of the ears.

For effective treatment of the fungus, timely diagnosis and early treatment of this disease is necessary.

Microscopic fungi are part of the human environment, and their total number on the planet approaches 1.5 million. Currently, about 69 thousand species of mushrooms have been studied, 400 of them are pathogenic for humans and cause diseases, united by the term “mycoses”.
The most common type of fungal infection of the skin and mucous membranes are superficial mycoses, which include keratomycosis, dermatomycosis, candidiasis. Keratomycosis is a group of fungal skin diseases in which pathogens affect only the stratum corneum of the epidermis. In our latitudes, the most common is multi-colored lichen, the causative agent of which is the fungi of the genus Malassezia. Folliculitis, rare disseminated infections, and seborrheic dermatitis also belong to skin lesions caused by these fungi. The role of fungi of the genus Malassezia in the initiation of exacerbations of some chronic dermatoses (atopic dermatitis, psoriasis, rosacea, etc.) is discussed [1].

Dermatomycosis
A very common type of dermatomycosis is characterized by a chronic, recurrent course of foot mycosis. Its main causative agent is Trichophyton rubrum. In addition to the feet, this fungus can affect large folds, vast areas of smooth skin (up to erythroderma) [2, 3]. Infection usually occurs in showers, swimming pools, baths, when using household items common with a sick person (towels, sponges, shoes, socks, etc.). Predisposing factors are excessive sweating of the feet, flat feet, tight shoes. The process for a long time (many months and years) can be asymptomatic or manifest minor symptoms in the form of mild peeling, maceration of the epidermis in the interdigital folds, peeling on the arch of the feet, periodically appearing minor itching. The chronic course and unsystematic short-term, and therefore unsuccessful treatment attempts lead to the unjustified conclusion that the disease cannot be cured. On the other hand, a prolonged asymptomatic course creates the illusion that the disease is not dangerous and does not create any problems. Both of these conclusions are completely wrong, since the infection continues to spread. The patient is a source of infection, especially for family members and for those with whom they use showers and a pool. In addition, violations of the integrity of the skin can become the entrance gate to a bacterial infection. Significantly increases the allergization of the body. The attached secondary microbial flora aggravates the course of fungal disease, further reducing the body’s defenses. In contact with mushrooms, such flora acquires increased resistance to antibacterial agents. The natural result of foot mycosis is a fungal infection of the nails – onychomycosis. Candidiasis is an infectious disease of the skin, mucous membranes and internal organs caused by the pathogenic effects of yeast-like fungi of the genus Candida, usually Candida albicans. The transition of these fungi from a saprophytic state to a parasitic state, and candidacy in candidiasis is facilitated by the inferiority of specific and non-specific defense factors.
It is not by chance that candidal lesions accompany immunodeficiency, infectious diseases, endocrinopathies, metabolic diseases, blood, and tumor processes. The World Health Organization attributes long-term recurrent candidiasis to AIDS markers. Most often, cutaneous candidiasis is manifested by the defeat of large folds, interdigital erosion, as well as paronychia. Especially difficult and prone to recurrence of candidiasis of the mucous membranes [1, 2].

Diagnosis The
clinical diagnosis of mycotic lesion must be confirmed laboratory. To detect the causative agent, a microscopic examination is carried out as follows: the material (scales, hair from the lesion) for dissolving keratin is treated with a 10-30% solution of caustic alkali and examined under a light microscope. Filamentous fungal hyphae or budding cells are markers of fungal infection. In the future, to clarify the type of pathogen fungus, a cultural study is carried out by sowing pathological material on nutrient media (original Saburo, Saburo on yeast water, Saburo without glucose). Crops are placed in a thermostat at 300C. Culture is determined on the basis of the study of the shape, surface character, color of the colonies and their microscopic features [1, 3]. Treatment of Mycosis of the skin even at the very early stages of development require compulsory treatment, the leading role in which belongs to antifungal drugs. Considering the chemical structure, four main groups of antifungal drugs are distinguished: polyenes (nystatin, natamycin, amphotericin B), azoles (itraconazole,
fluconazole, ketoconazole, isoconazole, econazole, bifonazole, clotrimazole), allylamines (terbinafine, naphtholphine). Other drugs are also used that are not interconnected by chemical structure (griseofulvin, undecylenic acid, chloronitrophenol, etc.) [3, 4]. Among antifungal agents in recent years, azoles in general and ketoconazole in particular have become very popular among specialists. The drug has a wide range of fungistatic and fungicidal activity against dermatophytes, yeast and molds. Its effect on the cell is due to the fact that it inhibits the synthesis of ergosterol, triglycerides and phospholipids – the necessary components of the cell wall of the fungus, blocks the germination of fungal spores into the mycelium. The drug acts on the oxidase-peroxidase system of fungi, leading to the accumulation of endoperoxides that destroy the organelles and the fungal cells themselves, which greatly facilitates their phagocytosis [1, 3, 4]. Ketoconazole can be used both for oral administration and for external use in the form of a cream. Inside, one tablet is prescribed once a day with meals with a small amount of water. The duration of treatment depends on the nosological form. Treatment is carried out under the mandatory control of the functional state of the liver and kidneys. The most effective tablets are in the treatment of patients with candidal lesions of the skin and mucous membranes, candida paronychia, mycosis of large folds, and versicolor. The drug quickly stops the phenomenon of pustulization, which is explained by the pronounced fungicidal, anti-inflammatory and antibacterial effect of ketoconazole. Ketoconazole cream is very convenient to use, because thanks to its powerful and long-lasting antifungal and antibacterial effect, it can be applied in a thin layer to affected skin areas only 1-2 times a day,
without having an unpleasant odor and without contaminating the laundry. Typically, the duration of treatment with a topical preparation is 4 weeks. The ketoconazole cream shows the greatest therapeutic efficacy in the treatment of pityriasis versicolor, smooth skin microsporia, candidiasis and foot mycosis, providing in most cases the clinical and mycological recovery of patients. The cream is well preserved, does not cause an allergenic and irritating effect on the skin, even in patients with a history of allergic manifestations. It is also advisable to use it for skin mycoses complicated by a secondary bacterial infection. The use of the representative of azoles ketoconazole in everyday clinical practice significantly expands the possibilities of treating fungal skin lesions, providing high efficiency in the treatment of even complicated clinical forms. The drug can be successfully used for the prevention of superficial mycoses with an increased risk of their development (persons from the “risk” group: military personnel, athletes, workers of hot shops, miners, etc.).

Sweating legs is a fairly common and unpleasant symptom. To one degree or another, this applies to most people. But some suffer from excessive sweating of the legs, and in this case, careful foot care is required.

It is impossible to deprive attention of such a seemingly unimportant disease in any case, since sweating of the legs can lead to fungal diseases, writes Ladyhealth.com.ua. Then you will have to spend twice as much effort so that your legs regain health. 

To do this, today in the piggy bank of cosmetic medicine there are more than enough various means: baths, lotions, exercises, etc. We will offer some of them to you, and you, having tried them all, using it one at a time or in combination, will surely be able to get rid of unnecessary sweating feet.

Baths are prepared according to one technique: 1 tsp. the herbal mixture is poured with 1 glass of boiling water, infused for 20-30 minutes. After that, they are ready for use.

As a rule, mixtures of several herbs or other components are used for baths. Infusion for the bath can be prepared, for example, by mixing in equal proportions the crushed root of the coil, oak bark and St. John’s wort and pour the mixture with boiling water. Then this mixture should be boiled for 5 minutes and let it brew. When the infusion has cooled sufficiently, you need to lower your feet into it for 15-20 minutes, after which you should thoroughly wipe your feet and use a powder consisting of equal parts of urotropin and talc.

You can prepare a decoction for a bath of oak bark, nettle and sage. The method of preparing the infusion and application of the bath is already known to you.

But for the treatment of foot sweating, it is not necessary to use only plant components. Regular use of vinegar baths will significantly reduce sweating in the legs. For the preparation of the bath, dilute 3 tsp. vinegar in 1 liter of water and hold the feet in this solution for 5 minutes.

Do not ignore the contrast shower and bath with salt. These procedures have no less effect in the treatment of excessive sweating.

But, in addition to these methods of treatment, daily special foot care is needed.

Infections that occur mainly in patients with local or general impaired immunity or immunodeficiency are called opportunistic. The deep mycoses and fungal infections occurring in the Netherlands belong exclusively to this category, although they are sometimes observed in patients who have no apparent immune disorders. In other parts of the world, endemic fungi are found that often cause deep infections in people with normal immunity, the so-called primarily pathogenic fungi, such as Blastomyces dermatitidis, Coccidioides immitis and Histoplasma capsulatum in the USA and Penicillium marneffei in Southeast Asia, mainly in Thailand . In rare cases, as an imported disease, these infections are observed in the Netherlands, and in immunocompromised patients the risk is much higher than in healthy ones.
Table 1. The relationship between host immunity and mycoses

Immunity Impaired	Superficial infection
	Candida
	deep	Asper-cryptogillus coccus
Nonspecific immunity
Reduction of the skin and mucous barrier	+	–	–	–
Intravascular catheter	–	+	–	–
Decreased resistance and colonization	+	–	±	–
Phagocyte deficiency	+	+	+	–
Specific immunity
Decrease in humoral immunity	–	–	–	–
Decrease in cellular immunity	+	±	+	+
Note. + obvious connection, -no connection, ± doubtful connection

The main causative agents of opportunistic mycoses in Holland are some species of Candida, Aspergillus and Cryptococcus neoformans. Less common are Mucorales (pathogens of mucosal mycosis), Pseudoallescheria boydii, Fusarium and Trichosporon beigelii. An increase in the intensity of treatment of hematological malignant neoplasms and an increase in the number of organ transplants, apparently, led to an increase in the number of opportunistic mycoses.
Possible relationships between fungus, host and treatment are shown in Fig. 1. The occurrence of generalized fungal infections is determined by the balance between the virulence of the fungus and the patient’s immunity. We will not consider virulence factors. Almost all parts of the immune system are involved in defense against fungal infections, but the role of specific host mechanisms in different fungal infections is different. We will consider this in more detail later when discussing the most important opportunistic mycoses.

Diagnosis of generalized mycoses is difficult, since it is often impossible to distinguish between colonization and infection (mainly with Candida infection), crops become positive only in the late stages of the disease, and currently there are no reliable serological techniques for routine diagnosis of most infections. The treatment of generalized mycoses is also complicated. Available drugs are ineffective (compared with the effectiveness of antibiotics against bacteria), and the use of older drugs, amphotericin B (arnfotericine B) and flucytosine (flucytosine), is limited by their toxicity. Impaired host immunity, insufficiently sensitive diagnostic methods and treatment imperfections are the reasons why mortality from generalized mycoses is still unacceptably high.

Predisposition and epidemiology. Most Candida infections are caused by C. albicans, but infections can also occur with species such as C. parapsilosis, C. krusei, C. tropicalis, and C. glabrata. Immunity is multifactorial precisely against Candida infections . Violation of the integrity of the skin and mucous membranes when using cytostatic drugs or burns, impaired colonization resistance due to the use of antibiotics, and hormonal imbalance (for example, in diabetes mellitus) play an important role in the pathogenesis of superficial Candida infections. Granulocytopenia and the presence of intravascular catheters are important risk factors for candidaemia. Factors causing the occurrence of superficial infections can also indirectly predispose to the development of candidaemia and deep infections. A recent epidemiological study has shown that this is mainly true for antibiotic use. Our own research has shown that in patients with granulocytopenia who are colonized by Candida and are receiving treatment for proven bacteremia, the incidence of candidaemia can reach up to 50%. The best prevention of deep Candida infections, in our opinion, is strict monitoring of the use of antibiotics in the hospital.

Violations of T-cell immunity that occur with the use of glucocorticosteroids and with AIDS lead exclusively to superficial infections of Candida. Deep infections in AIDS patients are observed only in the presence of granulocytopenia caused by HIV infection itself or taking myelosuppressive medications, or when a deep intravenous catheter for parenteral nutrition is administered to the patient.
For Candida infections, it is important to distinguish between superficial and deep infections. Oropharyngeal candidiasis is the most common superficial Candida infection. Vaginal candidiasis and a rare hereditary syndrome of chronic mucocutaneous candidiasis, which may be accompanied by endocrinopathies, are not considered in this article.
Oropharyngeal and esophageal candidiasis. The clinical manifestation of oropharyngeal candidiasis is most often pseudomembranous mucositis (“thrush of the mouth”), but other manifestations, such as acute erythematic mucositis, chronic atrophic candidiasis (such as angular cheilitis) and chronic hyperplastic candidiasis, are possible and are more difficult to diagnose based on clinical data. Oropharyngeal candidiasis in AIDS patients must be distinguished from “oral hairy leukoplakia”, which is most often limited to the edge of the tongue, and from sores caused by herpes simplex virus. Oropharyngeal candidiasis without a clear reason (poorly fitting denture, the use of antibiotics or glucocorticosteroids) is an indication for an HIV test. Ultimately, more than 70% of AIDS patients experience oropharyngeal candidiasis.
The most important symptoms of esophageal candidiasis are pain and impaired food passage. In many patients, symptoms are absent and the disease is detected by chance during an endoscopic examination. In patients with esophageal candidiasis, oropharyngeal candidiasis is not always present. If an AIDS patient with oropharyngeal candidiasis complains of esophagitis, it is reasonable to assume that the cause is Candida. Only in case of doubt in the diagnosis or treatment failure is endoscopy indicated. In other immunocompromised patients, such as those undergoing bone marrow transplantation, an invasive examination should be performed earlier, as they are more likely to have other diseases, such as esophagitis caused by herpes simplex virus or cytomegalovirus.

Candidemia in patients without granulocytopenia. This complication is observed mainly in patients in intensive care units after abdominal surgery, in those receiving parenteral nutrition and after treatment with broad-spectrum antibiotics. Fever is often the only symptom, and a positive blood culture on Candida is often a surprise. Given the risk of focal scattering, treatment is shown, in our opinion, even if there is only one positive sowing of shelter and . The situation is much more complicated if the patient in the intensive care unit with constant fever has a colonization of Candida respiratory, digestive and genitourinary tracts. Due to the fact that blood cultures often become positive only in the late stage, it is difficult to distinguish between colonization and invasive infection. Modern molecular biological studies may show that an isolated strain is identical to the strain by which the patient has previously been colonized. Empirical antifungal treatment is sometimes indicated to begin, even if it is not possible to clearly determine when exactly this treatment should have been started. However, the threshold for initiating antifungal therapy under these circumstances decreased, since less toxic fungostatic agents became available.
Disseminated candidiasis in patients with granulocytopenia. This is the most severe form of Candida infection. Fever, general malaise, and worsening general condition are the most important symptoms. Specific symptoms such as skin lesions or fungal lesions are absent in most cases. Sometimes disseminated candidiasis can manifest with sepsis or septic shock. Blood cultures often become positive only in the late stage of the disease or remain negative. There are no reliable serological tests for an early diagnosis. If there is no recovery from granulocytopenia, then mortality is very high, despite antifungal treatment. An autopsy often reveals common lesions of the heart (endocarditis, myocarditis), brain, liver, spleen and kidneys.
Deep localized candidiasis. Deep localized Candida infections, such as osteomyelitis, spondylodiscitis, arthritis, endophthalmitis, and liver abscess, are sporadically occurring. In most cases, candidaemia, which led to the appearance of a scattered lesion, goes unnoticed. In addition, deep localized infections can occur as ascending urinary tract infections, which happens in patients with diabetes mellitus or after a kidney transplant. In some cases, this can lead to the formation of the so-called fungus ball in the pelvis. Very rarely, Candida infection leads to isolated pneumonia. In the vast majority of immunocompromised patients with pulmonary infiltrate, in which Candida is sown from sputum, colonization occurs.
Chronic disseminated candidiasis. Initially, this disease was called hepatosplenal candidiasis. The new name is more accurate, since in addition to the liver and spleen, other organs, such as the kidneys, can be affected [4]. The classical clinical picture consists of a period of prolonged incomprehensible fever in a patient with leukemia, and the fever persists after recovery from granulocytopenia. The presence of abdominal pain of an indeterminate nature and increased activity of alkaline phosphatase in the blood should suggest a chronic disseminated candidiasis. The disease is diagnosed by ultrasound or computed tomography of the liver and spleen.
Punctures sometimes show the presence of characteristic content, but the results of sowing in most cases are negative. Failing antifungal treatment often interferes with further antileukemic treatment.

Aspergillus Infections

Aspergillus species can cause disease in humans in various ways. Allergic aspergillosis is a disease in which, due to the presence of Aspergillus spores, type 1 allergic reactions or external alveolitis occur in the bronchial tree. In principle, these diseases are treated with glucocorticosteroids. In the case of aspergilloma, saprophytic growth of Aspergillus in the previously existing cavity in the lung is noted. Next, we consider the clinical manifestations.
Aspergillus infections most often occur aerogenically due to spore inhalation. The most important predisposing factors for invasive infections of A. fumigatus and other Aspergillus species are neutropenia and prolonged use of high doses of glucocorticosteroids, mainly after bone marrow transplantation, as well as after kidney transplantation. Aspergillus infections often occur immediately in a group of individuals during construction work. Initially, these infections rarely occurred in HIV-seropositive patients, but have been reported more frequently in recent years. These infections occur mainly during the final stage of AIDS [5]. The most important invasive infections of Aspergillus are given in table. 3.

Rhinocerebral aspergillosis. Chronic sinusitis due to Aspergillus can occur in immunocompromised patients, mainly in tropical areas where there is intense contact with fungal spores. Acute sinusitis due to Aspergillus occurs only in immunocompromised patients, in most cases against the background of severe granulocytopenia. The most important symptoms are pain, swelling around the eye, retroorbital pain, then proptosis, chemosis and ophthalmoplegia of the eye develop. Due to blockage of the vessel, the formation of a blood clot and local necrosis, the infection can spread to the brain, resulting in a decrease in consciousness and epileptic seizures. The clinical picture cannot be distinguished from that of rhinocerebral mucosal mycosis, and this disease is often fatal. With severe sinusitis in a patient with graulocytopenia, therefore, the possibility of a fungal infection should always be considered. Diagnosis can be made by computed tomography, paranasal sinuses and biopsy. Intensive surgical treatment and high doses of amphotericin B are the means of choice, if the patient’s condition permits.
Pulmonary aspergillosis. The most important clinical manifestations are cough, fever and hemoptosis due to necrotizing pneumonia. However, these are already late symptoms of the disease. More often only fever is noted, and in the first instance there are slight deviations in the chest radiograph, which may not be. With the help of computed tomography, sometimes with a still normal chest x-ray, it is already possible to identify multinodular pulmonary foci with a halo or cavity characteristic of Aspergillus. Pneumonia caused by Aspergillus infection can give a picture of a lung infarction or even diffuse interstitial pneumonia on a chest x-ray. Inoculation of Aspergillus from sputum or bronchoalveolar fluid in an immunosuppressed patient is highly indicative of invasive aspergillosis and is an absolute indication for treatment. The final diagnosis (based on tissue biopsy results) often cannot be made due to coagulation problems. For serological diagnosis, there are the same limitations as in disseminated candidiasis. In the future, it may be possible to use molecular biological techniques to detect Aspergillus DNA.
Disseminated aspergillosis. In patients with persistent granulocytopenia, dissemination of infection to other organs may occur, most often from the focus of pulmonary aspergillosis. Foci of scattering can occur in the skin, which makes it possible to diagnose, in the bones or internal organs (liver, spleen, kidneys, thyroid gland). Localization in the brain (hematogenous abscess of the brain) is the most dangerous, it is characterized by very high mortality. Despite a common disseminated infection, Aspergillus is almost never able to be sown from blood or cerebrospinal fluid.
Chronic necrotizing Aspergillus pneumonia. Several years ago, it was not possible to recognize that patients with chronic pulmonary diseases receiving glucocorticosteroids may develop invasive aspergillosis. This disease was called chronic necrotizing Aspergillus pneumonia. The most important differences from the already considered Aspergillus pneumonia in patients with granulocytopenia are that the disease progresses slowly, dissemination to other organs occurs very rarely. The diagnosis is made on the basis of the clinical picture, Aspergillus culture from sputum or bronchoalveolar fluid and in the absence of other pathogens of chronic pneumonia, such as anaerobes and mycobacteria.

Cryptococcal meningitis

Cryptococcus neoformans is a ubiquitous yeast that can be isolated mainly from bird excrement. Meningitis due to C. neoformans is observed exclusively in patients with reduced T-cell immunity (see Table 1). In the past, this infection was observed in patients after transplants who received treatment with glucocorticosteroids or thymocytic immunoglobulin; in some patients it was not possible to indicate predisposing factors. Currently, we observe cryptococcal meningitis, mainly with HIV infection [6].
Cryptococcal meningitis occurs in the Netherlands in 4-10% of AIDS patients and is an indicator disease for the diagnosis of AIDS. The infection occurs aerogenically, but the primary pulmonary infection is often asymptomatic. The pia mater and the brain are the site of primary localization, as well as the prostate gland, where relapses can often occur.
Symptoms can range from mild headaches to severe clinical meningitis and coma.
Sometimes patients are treated with extra-neural manifestations, such as lung or skin lesions. A persistent headache in an HIV-seropositive patient is always an indication for lumbar puncture if CT scan of the brain does not find sufficient explanation for the complaints. Regardless of the cell number, the concentration of protein and glucose in the cerebrospinal fluid (these three indicators in a patient with cryptococcal meningitis may be normal), a patient with AIDS should always quantify cryptococcal antigens in the cerebrospinal fluid, since this test has high sensitivity and specificity. In approximately 75% of cases, cryptococci can become visible when stained with an East Indian ink preparation.
Ultimately, the diagnosis must be confirmed by a positive culture result.

Other systemic opportunistic mycoses

Other opportunistic mycoses are also increasingly recorded in the United States, but in the Netherlands they are still rare.

The most important infections are Mucoraceae, Pseudoallesheria boydii, Fusarium and Trichosporon beigelii.
Mucoric mycosis is an invasive fungal infection, the causative agents of which are most often the species Rhizopus, Rhizomucor, Mucor and Absidia, belonging to the genus Mucoraceae. In many ways, mucous mycosis is similar to invasive aspergillosis. In addition to patients with granulocytopenia, mucosal mycosis occurs in patients with ketoacidotically deregulated diabetes mellitus and in patients with iron accumulation disease, regardless of whether they received treatment with desferoxamine or not. As with aspergillosis, there are rinocerebral, pulmonary and disseminated forms. For treatment, it is important to distinguish between aspergillosis and mucosal mycosis, because Mucoraceae are always resistant to azole derivatives.
With Pseudoallesheria boydii infection, the clinical picture may be similar to that of aspergillosis. Differential diagnosis is extremely important because this fungus is resistant to amphotericin B.
Disseminated infections caused by Fusarium or Trichosporon beigelii are rare. Clinical characteristics are not very specific, the diagnosis is made mainly on the basis of positive blood culture results.

Exotic mycoses

The so-called primarily pathogenic fungi in the Netherlands are not endemic, but can be observed as imported diseases. Therefore, a thorough history of recent and past travels is crucial.
Histoplasmosis is caused by the dimorphic yeast fungus Histoplasma capsulatum and is sometimes observed in the Netherlands from natives of Suriname and Indonesia. Histoplasmosis can also occur in patients who have traveled throughout the United States, mainly in the states of Mississippi and Ohio. Primary infection may be asymptomatic or manifest as pneumonia. As with tuberculosis, an infection acquired at a young age can become manifest at an older age due to a decrease in immunity. Histoplasmosis in AIDS patients is most often manifested by disseminated infection with fever, general malaise, hepatosplenomegaly, damage to the skin and mucous membranes, and nodular pulmonary infiltrates. Diagnosis is by blood culture or biopsy of affected organs. Sometimes a diagnosis can be quickly made by directly examining a bone marrow aspirate, if the laboratory is specifically asked about it.
Penicillium marneffei infections are endemic in Southeast Asia, mainly in Thailand [7]. In HIV seropositive patients with fever, general malaise, papulopustular skin lesions, hepatosplenomegaly, anemia, and lung lesions who have traveled to Southeast Asia, a diagnosis of P. marneffei infection should be taken into account. In most cases, patients have advanced AIDS and the number of CD4 + lymphocytes does not exceed 100 • 1 O6 / L. Differential diagnosis of disseminated histoplasmosis, cryptococcosis and mycobacterial infections based on only clinical data is difficult, so the anamnesis of travel is extremely important here. The diagnosis is based on blood culture, bone marrow examination, or biopsy of affected organs.
Coccidioidomycosis, endemic in the southwestern United States (Arizona, New Mexico and Texas), and blastomycosis, endemic in the northern states of the United States, are very rarely seen as imported diseases.

Fungal skin diseases, unfortunately, recently – this is a very common phenomenon, widespread everywhere. It is quite difficult to deal with it and you can’t do without the help of a dermatologist. The fungus is expressed in different ways: peeling, skin discoloration, severe itching, inflammatory changes. Infection occurs when using household items infected with a fungus or in contact with the person who is their carrier.

All fungal skin diseases are divided into main groups:  

1. Dermatophytosis

2. Deep mycoses

3. Candidiasis

4. Keratomycosis

Dermatophytosis – affects the nails, hair and horny layers of the epidermis, expressed in a bright inflammatory reaction. This group includes: favus, microsporia, epidermophytosis and trichophytosis.

Deep mycoses are the most dangerous, since the fungus affects not only the skin and mucous membranes, but also the internal organs and the human nervous system.

Candidiasis – fungi that affect the skin, mucous membranes of the oral cavity, internal organs.

Keratomycosis is a group of fungi that is not manifested by absolutely no sensations and inflammations of the skin, which affects exclusively the horny layers of the skin. The diseases of this group include multi-colored lichen, erythrasma. Only a doctor can give recommendations regarding the treatment of fungal diseases, since when self-medicating, you can not heal the fungus, which at any opportunity attacks your body with renewed vigor.

If you notice that the nails on your hands or feet have changed color, become opaque and suddenly begin to thicken, then they may have overtaken a fungal infection. This disease is called onychomycosis. The word comes from two Greek ónyx – nail and mýkes – mushroom . Dermatomycetes (a group of fungi parasitizing on the skin), mold and yeast can cause damage.     

It is believed that nail fungus is a secondary infection. Initially, the skin of the feet or hands is affected. The probability of infection is affected by climatic conditions, age, gender, concomitant diseases, and even the profession. 

Climate

Fungal infection most often develops in conditions of heat and humidity. This contributes to the tropical and subtropical climate. But it is also quite common in temperate and cold climates. This is due to the need to wear warm shoes, which creates the same conditions of elevated temperature and humidity. 

Age

Most often, nail fungus is found in adults and the elderly. Recently, there have been cases of diseases in children and adolescents. It is believed that every 10 years, the risk of contracting onychomycosis increases 2.5 times. Contributing factors are a decrease in the rate of growth of nails, malnutrition of the nail bed, vascular disorders that appear with age.

Floor

Men suffer from nail fungus, especially on the legs, 1.5-3 times more often than women. But, oddly enough, women are more likely to see a doctor for help. 

Accompanying illnesses

The most common factors predisposing to the occurrence of onychomycosis are circulatory disorders in peripheral vessels, obesity, foot deformities, immunodeficiency states and diabetes mellitus. In diabetes, the likelihood of illness rises to 30%. The use of certain drugs, such as corticosteroids, antibiotics, and antitumor drugs, also affects.

Profession

It is noted that residents of megacities with developed industries are more likely to be affected by fungal infections of the nails than the inhabitants of rural areas. By occupation, miners, workers in the metallurgical industry, and technical personnel of nuclear power plants are most affected. One hundred is associated with factors such as dust, ionizing radiation, gas contamination, high temperature, etc. Also at risk are bath workers, massage therapists, laundry staff, medical staff, military and athletes.
If you do not belong to these professional groups, it does not mean that you are protected from nail fungus. Visiting pools, baths and saunas, public showers, massage rooms also puts you at risk.

Symptoms of nail fungus

Modern foreign and Russian dermatologists use the following classification of the disease:

1. Distal or distal – lateral onychomycosis. The most common form of nail fungus. The defeat begins with the edges of the nail. The fungus penetrates under the free (far, distal) edge or lateral (lateral) fold. The main processes in this infection do not occur in the nail plate itself, but under it in the nail bed. The nail loses its transparency, becomes yellowish or whitish. The edge of the nail begins to crumble, thinning. Although the nail looks thickened due to the fact that under it there is an excessive development of a layer of the skin called horny (hyperkeratosis). For a long time, such a lesion can occur in the form of a marginal one. It most often looks like white strips going down from the free edge of the nail.  
2.  Proximal subungal onychomycosis. This is a rare form of the disease. The fungus is introduced from the side of the posterior skin roller, where the cuticle is removed during manicure and pedicure. Then the lesion covers the matrix of the nail (its visible part is the hole). In the classic version of this kind of onychomycosis, a white spot first appears in the region of the hole, and then it spreads to the entire nail, reaching its free edge. 
3. White superficial onychomycosis. It appears in the form of white spots, stripes on the nail plate, going from the back roller to the free edge. Over time, they become larger, grow and become yellow. 
4. Total dystrophic onychomycosis . Total – means covering the entire nail. Dystrophic – in this case means the destruction of the nail plate. She looks very thickened, yellowish – gray, uneven. It can be destroyed partially or completely. In most cases, subungual hyperkeratosis of varying severity is observed.  

Do not wait for the manifestation of all the signs of fungal damage to the nail, and especially its final stages. If you find yourself with similar signs, then this is an occasion to consult a specialist.

Diagnostics 

In addition to the external signs of nail fungus, the doctor will also consider laboratory data on scraping the affected tissues. The laboratory will conduct a microscopic examination, identify the pathogen. Then they will sow to more accurately determine which variety of fungi caused the disease. 

Nail fungus treatment

Fungal infection is very persistent, it is necessary to take its treatment extremely seriously. After all, this is not just a cosmetic defect, but a disease.
Currently, the media is a huge amount of advertising of antifungal drugs. Basically, they are all external effects (ointments, gels, solutions).

Be skeptical of advertising slogans about a quick and absolute cure, since these tools do not completely cure nail fungus. They provide only symptom relief. Therefore, the most relevant and effective is a systematic approach to this problem.

Not only external but also internal agents (tablets) are used. Such a complex treatment can only be prescribed by a doctor. According to recent data, the most effective are those containing terbinafine and itraconazole. The treatment is long. The course of drugs can take from 6 to 12 weeks, depending on the severity of the disease. The result will be visible when a healthy nail is fully grown. It takes several months. Among other things, antifungal drugs have contraindications. 

Be sure to consult your doctor. Do not self-medicate to avoid unpleasant consequences. 

Can you imagine that our legs are a haven for almost 200 species of different mushrooms? As it turned out, mushrooms also have their favorite places on the human body. Human skin is home to many harmless mushrooms that can cause infection if they start to multiply. Favorite places for mushrooms between the toes, under the nails and on the heels. This information can well help specialists in solving problems of skin diseases, especially in people involved in sports.

In the UK, almost three out of every hundred people suffer from fungal infections of the nails, and the most common symptom of the disease is a thickening of the nail and a change in its color. When scientists examined mushroom samples taken from the ear canal, from the heel, thighs, neck, place behind the ear, from the forearm, and many other areas of the body, they found that fungal riches vary significantly in each of these areas. The highest concentrations of mushrooms are on the heel, which turned out to be home to almost 80 species of mushrooms.

This knowledge of mushrooms and how to deal with them through improved cleanliness and hygiene can help stop the spread of many dermatological diseases.

Vaginal infections are vaginitis caused by inflammation or infection of the vagina. Vaginal infection can affect both the vagina and the vulva. Vaginal infections can develop due to exposure to the vaginal microflora of pathogens, fungi or viral diseases. In addition, the vagina can become inflamed due to an allergy to certain compounds and substances that are part of intimate hygiene products, or, for example, a lubricant for condoms. In some fairly small cases, vaginal infections are transmitted through sexual contact. 

Signs of a vaginal infection

Signs of a vaginal infection are due to where the inflammation came from. In some cases, vaginal infections can develop without revealing themselves. The most common signs of vaginal infection are:

– abnormal discharge from the genitals, characterized by a sharp foul odor;

– burning and pain during urination;

– itching and scabies of the external genitalia and the area around the anus;

– pain during sexual intercourse;

Vaginal discharge and infection

Normally, the female genital organs secrete a mucus-like fluid daily, which is pale in color, does not irritate the external genitalia, and does not have a pungent odor. With the correct and regular menstrual cycle, the color, profusion and density of vaginal discharge is different. Sometimes a woman may notice vaginal discharge in the form of a small amount of a clear, odorless liquid. In the same cycle, quite abundant and dense discharge can be observed. But all these processes are part of the norm. 

Vaginal infections, characterized by the presence of a concomitant pungent odor, or those to which the body reacts with allergic reactions, are usually considered pathological. Itching and irritation of the vagina can be considered an allergic reaction. Itching may not give rest during the day, but usually becomes much stronger at night. As a rule, itching becomes even stronger after sexual contact. If a woman notes that the shade, smell, profusion or density of vaginal discharge has changed in quality, she needs to contact a gynecologist.   

Vaginal infections are divided into several types according to the type of pathogen. The most common are:

– fungal infections of the vagina: candidiasis (thrush);

– bacterial infections of the vagina;

– Trichomonas infections of the vagina;

– chlamydial infections of the vagina;

– vaginal infections that occur due to a viral disease;

– non-viral infections of the vagina.

Each vaginal infection can have its own clinical manifestations. Not every woman without professional help can independently determine what kind of infection is present in her. Moreover, even an experienced and qualified gynecologist can not immediately establish a variety of a particular vaginal infection. Moreover, one woman can suffer from vaginal infections of several varieties at once.

If we consider vaginitis in a broad sense, then we can say that they are fungal lesions of the female genitalia. The causative agent of this infection is the fungi of the Candida family. These bacteria are always present in a healthy body, localized in the oral cavity, genitals and gastrointestinal tract. 

Vaginal infections of fungal origin are characterized by thick, pale discharge. Meanwhile, this symptom may not always be present. In the process of infection of the genitalia with fungi, redness appears on the mucous membrane of the genital organs.

Thrush in infants is very common. Usually, thrush occurs in most babies, since this disease can manifest itself for many reasons, for example, poor hygiene when breastfeeding a child, with reduced protective properties of the immune system. In addition, thrush in infants may be a consequence of infection of the baby’s body during birth.

As a rule, thrush in infants is expressed in the form of a whitish coating, which covers the mucous membranes of the mouth. After removing this plaque, irritation and slight redness remains in its place. Thrush in infants becomes a cause of discomfort and entails a significant decrease in appetite in a child, up to a complete refusal to eat.

At the first stages of the disease, treatment of the disease should immediately begin in order to avoid the development of thrush. To cure a child, proper hygiene is required. It is mandatory to carry out the disinfection of pacifiers and nipples, feeding bottles and other children’s dishes. If the baby is breast milk, the nipples must be kept clean, wipe them with a weak solution of tea soda after each feeding.

In the event that thrush in infants has developed into a more complicated degree, it is required to consult a pediatrician about treatment. As a rule, doctors prescribe antifungal drugs to treat thrush in infants. To treat thrush of very young children, as a rule, special ointments and fluids are used to treat lesions. Drops based on nystatin and Candide antifungal liquid are very effective for treating thrush in infants. These tools require three times a day to process the oral cavity of the child. In addition, to maintain a normal state of the oral cavity, it should be treated with a weak solution of tea soda. If the mother is still breastfeeding, then in parallel with the treatment of the child, it is necessary to treat the mother herself. This measure is required to prevent re-infection.

As a rule, from thrush in infants there is not a trace left when they reach six months of age. If the treatment of thrush in infants does not have an effect, a full examination of the baby is required. The examination shows whether the child’s immune system is working correctly or not.  

Of course, the most effective treatment for thrush in infants is its prevention before the manifestation of the disease itself. Prevention of thrush in infants consists in observing the simplest rules of hygiene. Hygiene of the child consists in sterilizing all the children’s dishes, proper care of the condition of the nipples, if the mother breast-feeds the child. For all this, special tools are used. In addition, after each feeding, it is necessary to give the child a few teaspoons of boiled water. Water washes away the remains of food intake and, thus, prevents the growth of pathogenic bacteria in the oral cavity of the child. 

If thrush in infants develops, then treatment with antifungal drugs should immediately begin. These funds are prescribed to the child by a pediatrician. If the baby is breast-fed, then, as a rule, special fluids or ointments are prescribed for him to treat thrush. Ointments and liquids are treated several times every day with the site of the thrush. It is very useful to rinse the child’s oral cavity with a glycerol solution of borax 15%. Such a rinse disinfects the oral cavity, kills pathogenic bacteria. Of course, for the complete cure of a child suffering from thrush, it is also necessary to treat the mother at the same time. This is to avoid recurrence of infection. 

Pericarditis is an inflammatory process in the pericardial sac called the pericardium. Pericarditis is rarely considered an independent disease. As a rule, it develops as a complication after all kinds of diseases of an infectious and non-infectious nature.

Causes of Pericarditis

– infectious viral diseases, such as influenza, fungal diseases and microorganism infections;

– severe heart attack;

– immunological combinations of antibody-antigen that form during allergic reactions and accumulate in the tissues;

– intoxication of the body with poisons that can penetrate into the body from the external environment and from the inside of the body;

– complications after injuries.

With the development of the inflammatory process of the pericardium in the cavity, inflammatory or purulent exudate, blood clots or blood protein, fibrin can be delayed.

Pericarditis can be dry or exudative.

Dry pericarditis occurs with pressing pain in the chest area. As a rule, the pain is moderate, sometimes turning into more severe. They can be confused with pain in an angina attack. The patient during an attack of pericarditis is not able to take a deep breath, breathing is shallow and rapid. The pain becomes stronger when you press the chest in the area of ​​the heart muscle.

At the same time, heart palpitations and shortness of breath, paroxysmal cough, malaise and chills may occur . 

Exudative pericarditis, in fact, represents the second stage of dry. Moreover, all symptoms are more pronounced, difficulty breathing does not go away. When you click on the trachea, a dry and sonorous cough occurs. When you press the esophagus, difficulty swallowing appears, when you compress the nerve of the larynx, the voice changes or disappears altogether. The abdomen ceases to take part in the breathing process, since the diaphragm practically does not move.

Blanching, and then turning blue, is becoming more pronounced. Due to the stagnant process of venous blood, the upper limbs, head and neck begin to swell. The patient may feel general weakness. In this case, the pulse is felt very weakly. Patients have a fear of death. Often an attack of pericarditis leads to deep fainting.

Exudative pericarditis of a chronic nature, as a rule, develops over time. First there is mild shortness of breath and fatigue, then pain in the heart zone appears. All symptoms worsen over time.

Diagnosis of pericarditis

Diagnosis is based on a medical history, palpation and listening of the heart. To confirm the diagnosis, they resort to research using ultrasound, an x-ray apparatus and an electrocardiograph. In some cases of the disease, a pericardial sac is punctured. In the process of taking a puncture, a thin cannula is inserted into the pericardial cavity, with which a certain amount of accumulated fluid is taken for analysis. Exudate is examined in the laboratory. The specificity of the fluid taken during puncture allows us to judge the exact diagnosis.

Pericarditis treatment

Treatment of pericarditis is determined by the causes of its development. For example, in processes of an infectious nature antibiotics are prescribed, in case of allergic reactions – medications that inhibit the secretion of antibodies and so on.

In addition, they use anti-inflammatory and absorbable medicines. In severe cases of pericarditis, glucocorticoid hormones are prescribed. In addition, medications that relieve heart pain, normalize the functioning of the heart muscle and blood circulation are recommended.