Fungal Infections in Children

1981 ◽  
Vol 3 (2) ◽  
pp. 41-49
Author(s):  
Nancy Burton Esterly
Keyword(s):  
Fungal Infections ◽  
Positive Culture ◽  
Infectious Agent ◽  
Significant Degree ◽  
Childhood And Adolescence ◽  
Self Medication ◽  
Cutaneous Infections ◽  
Experienced Physician ◽  
Skin Conditions ◽  
Fungous Infection

Fungal disorders are some of the most common cutaneous infections of childhood and adolescence. Despite their frequency and the ease with which an infectious agent can be correctly identified, fungal lesions are readily mistaken for other diseases or misdiagnosed in patients with entirely different skin conditions. One of the chief reasons for inaccurate diagnosis is a preconceived notion on the part of the physician as to how the lesions should look clinically. In fact, cutaneous fungal infections are extremely pleomorphic in appearance and can be macular and scaly, papular, pustular, vesiculobullous, or nodular. Their morphology may also be altered by self-medication, by treatment prescribed by another physician, or by an immunologic deficit in the host. Even the most experienced physician will be baffled by these lesions some of the time. Studies assessing clinical acumen by verification with culture data demonstrate a significant degree of error in diagnosis, particularly in nondermatologic settings. Fortunately, most of these mistakes are preventable if three simple procedures are carried out. A Wood's lamp examination and a KOH preparation can be performed rapidly in the office and may provide all of the confirmatory evidence necessary for certain diagnosis. A positive culture of a properly obtained specimen is additional unqualified evidence of a fungous infection.

scholarly journals Prevalence and patterns of self-medication for skin diseases among medical undergraduate students

2018 ◽  
Vol 4 (2) ◽  
pp. 162
Author(s):  
Purna Pandya ◽  
Ishan Pandya
Keyword(s):  
Medical Students ◽  
Skin Diseases ◽  
Fungal Infections ◽  
Antifungal Drugs ◽  
Common Source ◽  
Western India ◽  
Self Medication ◽  
Medical Undergraduate ◽  
Dermatological Disorders ◽  
Skin Conditions

<p class="abstract"><strong>Background:</strong> Medical students are more prone to self-medication because of background knowledge and easy availability of medication. Dermatological disorders are affecting quality of life in adolescent and can motivate self-medication behaviour. The objective of the study was to study the prevalence and patterns of self-medication for skin conditions in among medical students.</p><p class="abstract"><strong>Methods:</strong> A cross-sectional questionnaire based study was carried out in medical students in western India. A self-administered questionnaire included information on socio-demographic details, general aspects of self-medication behaviour like used for which disease, drugs used, source of knowledge, reason for use etc. and analyzed.<strong></strong></p><p class="abstract"><strong>Results:</strong> Self-medication was prevalent in 90.09% participants for skin conditions. Mean age of participants was 20.35±1.23 years with male predominance. Most common skin conditions/symptoms for self-medication were acne (82.46%), sun tan (52.11%) followed by superficial fungal infections while common hair conditions were hair fall (80.10%) and dandruff (57.07%). The most commonly used drugs for self-medication were topical antifungal drugs (96.07%), sunscreen lotions (91.10%) and topical antimicrobials (80.10%). Most common source of information for self-medication was medical staff and seniors (92.67%) followed by internet (81.15%). Most common reasons for favoring self-medication were perceived the illness as minor/non-serious (62.83%) and time constraint (26.70%). 3.14% participants reported to have some adverse events with the drugs used by self-medication.</p><p class="abstract"><strong>Conclusions:</strong> Prevalence of self-medication for dermatological disorders was alarming high. Self-medication practices are highest for acne, superficial fungal infections, hair fall and dandruff. Proper training of medical undergraduates in diagnosis and treatment of dermatological problems with special emphasis on drug usage aspects are needed.</p>

Not just vegetations: focal myocardial changes in patients with fungal infections

2020 ◽  
pp. 1-6
Author(s):  
Nicole M. Cresalia ◽  
Sonal T. Owens ◽  
Terri L. Stillwell ◽  
Mark D. Norris ◽  
Sunkyung Yu ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Bacterial Infections ◽  
Fungal Infections ◽  
Positive Culture ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Similar Proportion ◽  
Retrospective Case ◽  
Fungal Endocarditis ◽  
Catheter Tip

Abstract Background: Fungal endocarditis classically involves dense heterogenous vegetations. However, several patients with fungal infections were noted to have myocardial changes ranging from focal brightening to nodular thickening of chordae or papillary muscles. This study evaluates whether these findings are associated with fungal infections. Methods: In a retrospective case–control study, paediatric inpatients with fungal infections (positive blood, urine, or catheter tip culture) in a 5-year period were matched 1:1 to inpatients without positive fungal cultures. Echocardiograms were scored on a 5-point scale by two independent readers for presence of myocardial brightenings, nodular thickenings, and vegetations. Clinical data were compared. Results: Of 67 fungal cases, positive culture sites included blood (n = 44), vascular catheter tip (n = 7), and urine (n = 29); several had multiple positive sites. “Positive” echo findings (score ≥ 2+) were more frequent in the Fungal Group (33 versus 18%, p = 0.04). Fungal Group patients with “positive” versus “negative” echo findings had similar proportion of bacterial infections. Among fungal cases, those with “positive” echo findings had longer hospital length of stay than cases with “negative” echos (median 58 versus 40 days, p = 0.03) but no difference in intensive care unit admission, extracorporeal membranous oxygenation support, or mortality. Conclusions: Myocardial and papillary muscle brightening with nodular thickening on echocardiogram appear to be associated with fungal infections. There may be prognostic implications of these findings as patients with “positive” echo have longer length of stay. Further studies are needed to better understand the mechanism and temporal progression of these changes and determine the prognostic value of this scoring system.

scholarly journals Mucormycosis of the hard palate masquerading as carcinoma

2012 ◽  
Vol 2 (1) ◽  
pp. 28 ◽  
Author(s):  
Bhari Sharanesha Manjunatha ◽  
Nagarajappa Das ◽  
Rakesh V. Sutariya ◽  
Tanveer Ahmed
Keyword(s):  
Clinical Presentation ◽  
Fungal Infections ◽  
Survival Rates ◽  
Positive Culture ◽  
Staining Technique ◽  
Necrotic Bone ◽  
Chronic Ulcers ◽  
Hematoxylin And Eosin ◽  
Clinical Differential Diagnosis ◽  
Hematoxylin And Eosin Stain

A growing number of medically compromised patients are encountered by dentists in their practices. Opportunistic fungal infections such as mucormycosis usually occur in immunocompromised patients but can infect healthy individuals as well. Mucormycosis is an acute opportunistic, uncommon, frequently fatal fungal infection, caused by a saprophytic fungus that belongs to the class of phycomycetes. Among the clinical differential diagnosis we can consider squamous cell carcinoma. Such cases present as chronic ulcers with raised margins causing exposure of underlying bone. There is a close histopathological resemblance between mucormycosis and aspergillosis. Microscopically, aspergillosis has septate branching hyphae, which can be distinguished from mucormycotic hyphae by a smaller width and prominent acute angulations of branching hyphae. A definitive diagnosis of mucormycosis can be made by tissue biopsy that identifies the characteristic hyphae, by positive culture or both. The culture of diseased tissue may be negative and histopathologic examination is essential for early diagnosis. Mucormycosis was long regarded as a fatal infection with poor prognosis. However with early medical and surgical management survival rates are now thought to exceed 80%. In the present case, the fungus was identified by hematoxylin and eosin stain and confirmed by Grocott’s silver methenamine special staining technique. Removal of the necrotic bone, which acted as a nidus of infection, was done. Post-operatively patient was advised an obturator to prevent oronasal regurgitation. Since mucormycosis occurs infrequently, it may pose a diagnostic and therapeutic dilemma for those who are not familiar with its clinical presentation.

scholarly journals Cutaneous manifestations of diabetes mellitus: a clinical study

2018 ◽  
Vol 4 (3) ◽  
pp. 352
Author(s):  
Nancy Bhardwaj ◽  
Samarjit Roy ◽  
Rashmi Jindal ◽  
Sohaib Ahmad
Keyword(s):  
Diabetes Mellitus ◽  
Bacterial Infections ◽  
Fungal Infections ◽  
Tertiary Care ◽  
Diabetic Control ◽  
Diabetic Patients ◽  
Tertiary Care Centre ◽  
Cutaneous Manifestations ◽  
Female Ratio ◽  
Cutaneous Infections

<p class="abstract"><strong>Background:</strong> Diabetes mellitus is a leading cause of morbidity with adverse effects on various systems including skin. Cutaneous manifestations seen in diabetes aid in its diagnosis and some of them may also correlate with diabetic control, duration and other complications. This study was undertaken to estimate burden of skin disorders among diabetics in a tertiary care centre of Uttarakhand.</p><p class="abstract"><strong>Methods:</strong> The study was conducted at Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India, over a period of one year from January 2016 to December 2016. Three hundred and seventy seven patients irrespective of age and sex were included in the study and those with gestational diabetes were excluded. Patients were examined for mucocutaneous manifestations and evaluated. Structured case reporting form was used to generate data.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 377 patients studies, 114 (30.2%) were in the age group of 51-60 years. Male to female ratio was 1.44:1. Mucocutaneous manifestations were present in 278/377 (73.7%) patients. Common cutaneous manifestations were cutaneous infections [fungal infections (n=106/377; 28.1%), bacterial infections (n=33/377; 8.8%)], pruritus (n=47/377; 12.5%), xerosis (n=39/377; 10.3%), diabetic dermopathy (n=36/377; 9.5%) and diabetic ulcers (n=24/377; 6.4%). Uncommon manifestations were necrobiosis lipoidica diabeticorum, alopecia areata, scleredema diabeticorum and granuloma annulare. Cutaneous reactions due to treatment of diabetes were noted in 4 (1%) patients.</p><p class="abstract"><strong>Conclusions:</strong> As prevalence of cutaneous manifestations is high in diabetic patients, knowledge of these will help in a timely and comprehensive management of both diabetes and dermatoses.</p>

scholarly journals Generating evidences on rational management of dermatophytic infections

2020 ◽  
Vol 6 (6) ◽  
pp. 821
Author(s):  
Safi Abbas Rizvi ◽  
Som Lakhani
Keyword(s):  
Adverse Effects ◽  
Fungal Infections ◽  
Diagnostic Tools ◽  
Fungal Culture ◽  
Steroid Abuse ◽  
Rational Management ◽  
Polymerase Chain ◽  
Chronic Skin ◽  
Skin Conditions ◽  
Prevention And Cure

<p class="abstract">Superficial fungal infections are globally responsible for 25% of the skin mycoses cases. Dermatophytosis is a type of superficial fungal infection of skin, a significant cause of morbidity in the world. This pilot study includes most recent literatures with highest ratings and published work which has been submitted in last fifteen years. The literature review is completely oriented in reviewing evidence which includes the type of dermatophytic infection, diagnostic tools, therapeutic and non-therapeutic management of dermatophytic infection having highest level of evidences. Clinical diagnosis of dermatophytic infection and laboratory-based tests are vital in management of dermatophytic infections, considering conventional methods and incorporation of advanced techniques like preparation of skin specimens for microscopic examination by 10% to 20% mount microscopy, polymerase chain reaction, fungal culture, and spectroscopy. Over-use of corticosteroid is strictly discouraged as they carry multiple cutaneous adverse effects. A vast gap is evident in the management of dermatophytic infection with available reviews. Steroid abuse, in dermatophytic infection has led to many adverse effects and chronic skin conditions. Prevention and cure needs support of awareness about the disease and its severity.</p>

scholarly journals Molecular Detection, not Extended Culture Incubation, Contributes to Diagnosis of Fungal Infection

2020 ◽  
Author(s):  
Alex Zhu ◽  
Chao Qi
Keyword(s):  
Molecular Detection ◽  
Susceptibility Testing ◽  
Fungal Infections ◽  
Positive Culture ◽  
Laboratory Diagnosis ◽  
Fungal Culture ◽  
Low Sensitivity ◽  
Slow Growing ◽  
Culture Negative ◽  
Its Pcr

Abstract Background. Despite of low sensitivity, fungal culture remains one of the key methods for diagnosing and treatment of fungal infections as it identifies etiology at genus and species level and offers susceptibility testing. The Manual of Clinical Microbiology recommends that fungal cultures screening for all pathogens should routinely be held for 4 weeks to maximize the recovery of slow growing species. Information on the optimal fungal culture time in the era of expansion of immunocompromised populations is lacking. The goal is to review our experience with fungal culture in order to determine the optimal culture incubation time; to review our experience of broad-range ITS PCR for diagnosis of culture negative fungal infections. Methods. Fungal culture and ITS PCR results from January 1, 2013 to December 31, 2017 were reviewed.Results. Ninety six percent of positive cultures (4058) were detected in the first seven days of incubation. During the second week of incubation, 2.8% of positives (111) were detected from day 8 to 10, and 1.7% (71) were detected from day 11 to 14. Only 0.1% of positive culture were detected in the third week of incubation, and no positive culture was detected in the fourth week of incubation. No Clinical significance of fungal isolates recovered after 14 days. Clinical significant pathogens were detected in 0.2% culture negative samples.Conclusion. Extending culture incubation beyond two weeks did not generate clinical relevant results. When culture failed to make laboratory diagnosis, ITS PCR produced clinical significant results.

Fungal skin infections

2021 ◽  
Vol 32 (10) ◽  
pp. 407-413
Author(s):  
Margaret Perry
Keyword(s):  
Fungal Infections ◽  
Healthcare Services ◽  
Evidence Based ◽  
Skin Infections ◽  
Significant Issue ◽  
Duration Of Treatment ◽  
Evidence Based Treatment ◽  
Skin Conditions

Fungal infections of the skin continue to place a burden on healthcare services. Margaret Perry provides an overview of the most common conditions Fungal infections of the skin continue to place a burden on healthcare and are a significant issue globally in terms of their cost and impact on resources. Some are more difficult to treat than others and there is a wide variation in duration of treatment, depending on the site and severity. Many fungal infections share similarities in appearance with other skin conditions, which can sometimes make diagnosis difficult. This article details some of the most common conditions and aims to give nurses and non-medical prescribers an overview of evidence-based treatment and management as well as to increase confidence when managing some of these troublesome diseases.

scholarly journals 748. Epidemiology and Outcomes of Invasive Fungal Infections Following Civilian Trauma

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S421-S421
Author(s):  
Patrick B Mazi ◽  
Grant Bochicchio ◽  
Kelly M Bochicchio ◽  
Stephen Liang ◽  
Lindsey Larson ◽  
...  
Keyword(s):  
Soil Contamination ◽  
Fungal Infections ◽  
Traumatic Injury ◽  
Positive Culture ◽  
Invasive Fungal Infections ◽  
Fungal Culture ◽  
Civilian Population ◽  
Patient Demographics ◽  
Post Traumatic ◽  
A Site

Abstract Background Invasive fungal infections (IFI) following traumatic injury are devastating complications that threaten life and limb. In military combat wounds, post-traumatic IFI patients have up to 6 times higher mortality rates and 2.6-5.1 times higher rate of high-level amputations compared to non-IFI patients, though no such data exists for the civilian population. This study is the first cohort to analyze a post-traumatic civilian population for IFI, its epidemiology and outcomes. Methods We conducted a single-center retrospective cohort study of all trauma patients over the age of 18 years admitted to a large tertiary referral hospital between 2004 to 2015 who required surgery for their injury and had operative cultures submitted from their wounds. Patient demographics, comorbid conditions, mechanisms of trauma, environmental exposures, and laboratory data were included for analysis. Patients with positive culture for fungus from a site compatible with IFI were considered IFI patients. Data was analyzed using descriptive statistics with p≤0.05 considered significant. Results Our cohort includes 1,107 patients that met inclusion criteria. Of these, 120 patients had a positive culture for fungus, 454 patients had a positive culture for bacteria and 533 patients had no positive culture from a site of interest. Basic patient demographics, geographical setting of the trauma, and anatomical site of injury were not significantly associated with having a positive fungal culture. Necrosis was present in 19 (15.8%) IFI vs. 74 (7.5%) non-IFI patients (p=0.002). Soil contamination of a wound was present in 6 (5.0%) IFI vs. 11 (1.1%) non-IFI patients (p=0.001). 55.8% of 120 IFI wounds penetrated below fascial layers compared to 26.7% of 987 non-IFI wounds (p&lt; 0.001). Presence of IFI increased likelihood of requiring amputation (6.7% vs. 2.7%, p=0.02) and prolonged hospitalization &gt;14 days (77.5% vs. 57.4%, p&lt; 0.001) compared to those without. Conclusion IFI significantly increased patient risk for amputation and prolonged hospital length of stay following traumatic injury in a civilian population. Presence of IFI was associated with wounds penetrating below the fascial layer, presence of wound necrosis, and soil contamination of a wound. Disclosures Andrej Spec, MD, MSCI, Astellas (Grant/Research Support)Mayne (Consultant)Scynexis (Consultant)

scholarly journals Pattern of geriatric dermatoses at a tertiary care center in North-East India

2017 ◽  
Vol 3 (4) ◽  
pp. 527 ◽  
Author(s):  
Sandhyarani Kshetrimayum ◽  
Nandakishore Singh Thokchom ◽  
Vanlalhriatpuii . ◽  
N. A. Bishurul Hafi
Keyword(s):  
Fungal Infections ◽  
Care Center ◽  
Tertiary Care ◽  
Systemic Diseases ◽  
Contributing Factors ◽  
Self Medication ◽  
Cross Sectional ◽  
Female Ratio ◽  
North East ◽  
Lichen Simplex Chronicus

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">The aging population is dramatically increasing with the increase in the average life. It is faced with different health problems which include skin as well. The aim was to study the clinical pattern of geriatric dermatoses and associated systemic diseases.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A cross-sectional study was conducted for a period of 18 months to study the pattern of geriatric dermatoses on 250 geriatric patients aged above 60 years attending Dermatology OPD, RIMS, Imphal</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Out of 250 patients 136 were males and 114 were females. The mean age was 67.28 years and the male to female ratio was 1.19:1. Majority of the patients belonged to the 60-69 age group (66%). 63.2% had the dermatosis for more than 1 month before presentation. The most common dermatoses were: infections (26.4%), eczemas (22.4%), papulosquamous (10.4%), photodermatoses (8.0%) and infestations (6.8%). Herpes zoster (13.2%) and superficial fungal infections (7.6%) was the most common infections. Lichen simplex chronicus (6%). was the main form of eczema. Psoriasis (6%) and lichen planus (4.4%) were the common papulosquamous disorders. Chronic actinic dermatitis (6%) represented as the main pattern of photodermatoses. Uncommon disorders were tumors (4%), immunobullous (2.6%), drug reaction (2.4%), vitiligo (2%) and alopecia areata (0.8%).</span><span lang="EN-IN"> Main co-morbid systemic diseases were hypertension (16.4%) and diabetes mellitus (6.8%). </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Different disease entities in the elderly demands different approach to management. Contributing factors like neglect, delay in seeking treatment, co-morbidities have to be properly addressed. Health education on proper skin care, avoidance of irritants and self-medication etc would help reduce the incidence of common dermatoses.</span></p>

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