DOCSLIB.ORG

Leaders J Clin Pathol: First Published As 10.1136/Jcp.49.2.95 on 1 February 1996

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Leaders J Clin Pathol: First Published As 10.1136/Jcp.49.2.95 on 1 February 1996 I Clin Pathol 1996;49:95-99 95 Leaders J Clin Pathol: first published as 10.1136/jcp.49.2.95 on 1 February 1996. Downloaded from Mycological techniques K G Davey, C K Campbell, D W Wamock Introduction possible from the free edge of the nail and Laboratory tests are essential to establish the should include its full thickness. Specimens diagnosis of a fungal infection. The methods should be taken from several nails if more than used are based on three broad approaches: (1) one is affected. Debris beneath infected nails the detection ofthe pathogen in tissue on direct often contains the fungus. microscopic examination; (2) its isolation and It is sometimes helpful to use a Wood's lamp identification in culture; and (3) the detection to select infected scalp hairs for investigation. of an immunological response to the pathogen. Ifnone ofthe hairs gives the green fluorescence This Broadsheet describes the collection of which is characteristic of some microsporum clinical specimens from patients with suspected infections, a search should be made for lustre- fungal infection and outlines appropriate test less hairs or stumps and for hairs broken off procedures for the detection, isolation and at follicle mouths. Hairs should be extracted identification of fungal pathogens. It does not from the scalp using flat-ended forceps. Cut cover the serological diagnosis of fungal in- hairs without roots are unsuitable for my- fection. cological examination. Skin scrapings should also be collected from sites where fungal in- fection of hairs is suspected. Collection of specimens Another method which is useful for the col- It is important to provide the laboratory with lection of adequate material from patients with adequate specimens for investigation together suspected scalp infection not detectable under with sufficient clinical information about un- a Wood's lamp is to brush the scalp with a derlying illness, recent travel or previous res- plastic massage pad (available from most chem- idence abroad, animal contacts, and the ists), which is then pressed into the surface of patient's occupation if considered relevant. an agar plate. The pad should be sterilised in http://jcp.bmj.com/ With the exception of skin, nails and hair, all 1 % chlorhexidine for one hour, rinsed in sterile samples should be collected in sterile con- water and dried before being reused. tainers. MUCOUS MEMBRANES SKIN, NAILS AND HAIR Swabs moistened in sterile water or saline nails and hair should be Skin, collected into should be used to collect exudate or discharge. on September 25, 2021 by guest. Protected copyright. folded squares of stiff black paper (about The swabs should be sent to the laboratory in 10 x 10 cm). These can now be purchased from a standard transport medium. a number of commercial suppliers (Dermaco, PO Box 470, Toddington, Bedfordshire LU5 6BK; MycoTrans, PO Box 1172, Biggar, Lan- EAR arkshire ML12 6NN). It is essential to clean Scrapings of material from the ear canal are to superficial lesions with 70% alcohol prior to be preferred, although swabs can also be used. This Broadsheet has been sampling if ointments, creams or powders have prepared by the authors at the been applied. Ifpityriasis versicolor is a possible invitation of the Association of EYE Clinical Pathologists who diagnosis, the affected sites should be examined Material from a corneal ulcer with a suspected reserve the copyright. Further under ultraviolet light (Wood's lamp). The copies of this Broadsheet may fungal cause should be scraped with a sterile be obtained from the Publishing characteristic golden yellow fluorescence often platinum spatula, sampling both the base of Manager, 3rournal of Clinical associated with this infection can help in the Pathology, BMA House, the ulcer and the edges. This procedure should Tavistock Square, selection of skin scrapings. London WClH 9JR. be performed by an eye specialist. Because the Material should be collected from cutaneous amount of material that can be obtained will PHLS Mycology lesions by scraping outwards from the margin be small, it is best transferred to a glass slide Reference Laboratory, of the lesion with a blunt scalpel. If there is for microscopic examination and to an agar Public Health minimal clear tape as Laboratory, scaling, adhesive such plate for culture at the bedside. The culture Kingsdown, sellotape can be used to remove material for plate should be marked to indicate the point Bristol BS2 8EL examination. The sellotape strip is pressed of inoculation. K G Davey against the lesion, peeled off and placed, ad- Swabs are not suitable for sam- C K Campbell pling comeal lesions. D W Wamock hesive side down, on a clean glass microscope slide for transportation to the laboratory. Correspondence to: Dr D W Wamock. Nail scrapings or clippings should be taken BLOOD Accepted for publication from discoloured or dystrophic parts of the Blood culture is an important part of the in- 26 September 1995 nail. Specimens should be cut as far back as vestigation of suspected deep fungal infection. 96 Davey, Campbell, Warnock However, microbiologists should not expect Characteristics of some common dermatophytes invading blood cultures taken for bacterial isolation to hair detect fungal pathogens other than Candida Arthrospore size J Clin Pathol: first published as 10.1136/jcp.49.2.95 on 1 February 1996. Downloaded from spp., Cryptococcus neoformans, or Thichosporon Fungus (oIm) Arrangement spp. Isolation of fungi from blood depends on Microsporunm audouinii Small (2-5) Ectothrix a number of factors including the amount of Microsporum canis Small (2-5) Ectothrix Trichophyton mentagrophytes Small (3-5) Ectothrix blood sampled and the method of processing. Trichophyton tonsurans Large (4-8) Endothrix Commercial biphasic and Bactec blood culture Tichophyton violaceuni Large (4-8) Endothrix systems will often permit the detection offungal Tnchophyton verrucosum Large (5-10) Ectothrix infection. SPUTUM AND BRONCHOALVEOLAR LAVAGE Fresh early morning samples of sputum are men consists ofmore than one piece ofmaterial, ideal. These should be collected in sterile con- it is advisable to use some of each for mi- tainers and processed within two hours of col- croscopic examination and culture. Hairs lection. If delay in processing is unavoidable, should first be examined under a Wood's lamp specimens should be stored at 4°C. More in- and fluorescent parts, if present, used for pro- vasive sampling methods are often required to cessing. Hairs should be cut about 5 mm above obtain specimens from neutropenic patients. the root and the upper portion discarded. Se- Broncheoalveolar lavage (BAL) provides useful lected fragments or roots are placed in a large samples for direct microscopic examination and drop of 20% potassium hydroxide (KOH) on culture. a microscope slide and a coverslip placed on top. The slide should be set to one side to soften and clear the material. Skin material will CEREBROSPINAL FLUID, URINE AND OTHER clear in 15 to 20 minutes, as will thin nail FLUIDS parings and sub-ungual debris, but thicker nail Cerebrospinal fluid samples of 3-5 ml are ideal, fragments can take 30 to 60 minutes to soften. but are usually smaller than this. Samples can Gentle warming ofpreparations will reduce the be centrifuged and the supematant fluid used time required for clearing, but care must be for serological tests. The sediment can be cul- taken to avoid boiling. tured, but is also useful for direct microscopic Once skin or nail material has digested, the examination. In non-catheterised patients, coverslip should be pressed down to squash fresh mid-stream specimens of urine are ad- out the fragments and render them transparent, equate for mycological investigation, provided blotting off the excess KOH. Hair specimens care is taken to ensure that vaginal or perineal should not be heated or squashed as infected infection does not lead to contamination. In hairs will disintegrate and the diagnostic ar- http://jcp.bmj.com/ infants, suprapubic aspiration is the best rangement of the arthrospores will be lost. method of urine collection. Other fluids, Low power magnification ( x 10 objective) is whether aspirated or drained, should be col- adequate for the detection of fungal hyphae in lected into sterile containers which include a KOH preparations, but a higher power ( x 40 small amount of sterile heparin diluted 1 in objective) is often required to confirm their 1000 to prevent clotting. These specimens presence. Septate hyphae which may consist of should be centrifuged and the sediment cul- chains of rectangular spores (termed ar- on September 25, 2021 by guest. Protected copyright. tured. Drain fluid from patients receiving con- throspores) are typical of dermatophyte in- tinuous peritoneal dialysis should be collected fection. In cases of pityriasis versicolor, the into sterile containers without heparin. fungus (Malassezia furfur) appears as clusters of round cells together with short, unbranched hyphae. If a hair specimen is found to be PUS, BONE MARROW AND TISSUE infected, the size of the arthrospores and their If possible, swabs should not be used to collect arrangement should be noted (table). material from draining abscesses or ulcers. If a Care must be taken to distinguish fungal swab must be used, then material should be hyphae from the artefact known as "mosaic". taken from as deep as possible within the lesion. This is thought to be caused by deposition of Pus from undrained subcutaneous abscesses or cholesterol and, unlike true fungus, it tends to sinus tracts should be collected with a sterile follow the outlines of the epidermal cell walls. needle and syringe. If grains are visible in the Methods for selective staining of fungal hyphae pus (as in mycetoma), these must be collected. are available, but are seldom required. Bone marrow specimens should be collected The recognition of fungal hyphae and/or ar- into sterile containers which include a small throspores by direct microscopic examination amount of sterile heparin diluted 1 in 1000.
Load more

Recommended publications
  • Introduction to Bacteriology and Bacterial Structure/Function
    INTRODUCTION TO BACTERIOLOGY AND BACTERIAL STRUCTURE/FUNCTION LEARNING OBJECTIVES To describe historical landmarks of medical microbiology To describe Koch’s Postulates To describe the characteristic structures and chemical nature of cellular constituents that distinguish eukaryotic and prokaryotic cells To describe chemical, structural, and functional components of the bacterial cytoplasmic and outer membranes, cell wall and surface appendages To name the general structures, and polymers that make up bacterial cell walls To explain the differences between gram negative and gram positive cells To describe the chemical composition, function and serological classification as H antigen of bacterial flagella and how they differ from flagella of eucaryotic cells To describe the chemical composition and function of pili To explain the unique chemical composition of bacterial spores To list medically relevant bacteria that form spores To explain the function of spores in terms of chemical and heat resistance To describe characteristics of different types of membrane transport To describe the exact cellular location and serological classification as O antigen of Lipopolysaccharide (LPS) To explain how the structure of LPS confers antigenic specificity and toxicity To describe the exact cellular location of Lipid A To explain the term endotoxin in terms of its chemical composition and location in bacterial cells INTRODUCTION TO BACTERIOLOGY 1. Two main threads in the history of bacteriology: 1) the natural history of bacteria and 2) the contagious nature of infectious diseases, were united in the latter half of the 19th century. During that period many of the bacteria that cause human disease were identified and characterized. 2. Individual bacteria were first observed microscopically by Antony van Leeuwenhoek at the end of the 17th century.
    [Show full text]
  • Boards' Fodder
    boards’ fodder Medical Mycology By Adriana Schmidt, MD, and Natalie M. Curcio, MD, MPH. (Updated July 2015*) SUPERFICIAL ORGANISM CLINICAL HISTO/KOH TREATMENT MYCOSES* Pityriasis Malessezia furfur Hypo- or hyper-pigmented Spaghetti & meatballs: Antifungal shampoos and/or versicolor macules short hyphae + yeast PO therapy Tinea nigra Hortaea werneckii (formerly Brown-black non-scaly Branching septate hyphae Topical imidazoles or palmaris Phaeoannellomyces werneckii) macules + budding yeast allylamines Black piedra Piedraia hortae Hard firm black Dark hyphae around concretions acrospores Cut hair off, PO terbinafine, White piedra Trichosporon ovoides or inkin Soft loose white Blastoconidia, imidazoles, or triazoles (formely beigelii) concretions arthroconidia Fluorescent small Microsporum Canis KOH: spores on outside spore ectothrix: M. audouinii of the hair shaft; “Cats And Dogs M. distortum Wood’s lamp --> yellow Sometimes Fight T. schoenleinii fluorescence & Growl” M. ferrugineum+/- gypseum Large spore Trichophyton spp. (T. tonsurans in North America; T. violaceum in KOH: spores within hair Topical antifungals; PO endothrix Europe, Asia, parts of Africa). shaft antifungals for T. manuum, Tinea corporis T. rubrum > T. mentag. Majocchi’s granuloma: T. rubrum capitis, unguium T. pedis Moccasin: T. rubrum, E. floccosum. Interdigital/vesicular: T. mentag T. unguium Distal lateral, proximal and proximal white subungual: T. rubrum. White superficial: T. mentag. HIV: T. rubrum SUBQ MYCOSES** ORGANISM TRANSMISSION CLINICAL HISTO/KOH TREATMENT
    [Show full text]
  • Therapies for Common Cutaneous Fungal Infections
    MedicineToday 2014; 15(6): 35-47 PEER REVIEWED FEATURE 2 CPD POINTS Therapies for common cutaneous fungal infections KENG-EE THAI MB BS(Hons), BMedSci(Hons), FACD Key points A practical approach to the diagnosis and treatment of common fungal • Fungal infection should infections of the skin and hair is provided. Topical antifungal therapies always be in the differential are effective and usually used as first-line therapy, with oral antifungals diagnosis of any scaly rash. being saved for recalcitrant infections. Treatment should be for several • Topical antifungal agents are typically adequate treatment weeks at least. for simple tinea. • Oral antifungal therapy may inea and yeast infections are among the dermatophytoses (tinea) and yeast infections be required for extensive most common diagnoses found in general and their differential diagnoses and treatments disease, fungal folliculitis and practice and dermatology. Although are then discussed (Table). tinea involving the face, hair- antifungal therapies are effective in these bearing areas, palms and T infections, an accurate diagnosis is required to ANTIFUNGAL THERAPIES soles. avoid misuse of these or other topical agents. Topical antifungal preparations are the most • Tinea should be suspected if Furthermore, subsequent active prevention is commonly prescribed agents for dermatomy- there is unilateral hand just as important as the initial treatment of the coses, with systemic agents being used for dermatitis and rash on both fungal infection. complex, widespread tinea or when topical agents feet – ‘one hand and two feet’ This article provides a practical approach fail for tinea or yeast infections. The pharmacol- involvement. to antifungal therapy for common fungal infec- ogy of the systemic agents is discussed first here.
    [Show full text]
  • Tinea Capitis: Current Concepts in Clinical Practice
    CONTINUING MEDICAL EDUCATION Tinea Capitis: Current Concepts in Clinical Practice Matthew J. Trovato, MD; Robert A. Schwartz, MD, MPH; Camila K. Janniger, MD GOAL To understand tinea capitis to better treat patients with the condition OBJECTIVES Upon completion of this activity, dermatologists and general practitioners should be able to: 1. Describe the etiology of tinea capitis. 2. Recognize and diagnose tinea capitis. 3. Effectively treat tinea capitis. CME Test on page 88. This article has been peer reviewed and is accredited by the ACCME to provide continuing approved by Victor B. Hatcher, PhD, Professor of medical education for physicians. Medicine, Albert Einstein College of Medicine. Albert Einstein College of Medicine designates Review date: January 2006. this educational activity for a maximum of 1 This activity has been planned and implemented category 1 credit toward the AMA Physician’s in accordance with the Essential Areas and Policies Recognition Award. Each physician should of the Accreditation Council for Continuing Medical claim only that credit that he/she actually spent Education through the joint sponsorship of Albert in the activity. Einstein College of Medicine and Quadrant This activity has been planned and produced in HealthCom, Inc. Albert Einstein College of Medicine accordance with ACCME Essentials. Drs. Trovato, Schwartz, and Janniger report no conflict of interest. The authors discuss off-label use of fluconazole, itraconazole, ketoconazole, and terbinafine. Dr. Hatcher reports no conflict of interest. Tinea capitis is a common infection, particularly seen in Europe and many other countries, which among young children in urban regions. The emit a green fluorescence. However, T tonsurans, infection often is seen in a form with mild scaling like other fungi, also may less often produce an and little hair loss, a result of the prominence of intense inflammatory reaction, which is sugges- Trichophyton tonsurans (the most frequent cause tive of an acute bacterial infection.
    [Show full text]
  • STUDIES on INVASIVE KERATINOPHILIC DERMATOPHYTES of HUMAN HAIR *Brajesh Kumar Jha1, S
    Brajesh et al Journal of Drug Delivery & Therapeutics; 2013, 3(2), 70-74 70 Available online at http://jddtonline.info RESEARCH ARTICLE STUDIES ON INVASIVE KERATINOPHILIC DERMATOPHYTES OF HUMAN HAIR *Brajesh Kumar Jha1, S. Mahadeva Murthy2 1Research Scholar, Department of Microbiology, Yubraja College, Mysore, India 2Associate Professor, Department of Microbiology, Yubraja College, Mysore, India *Corresponding Author’s Email: [email protected] Phone: +977- 9845087892 ABSTRACT: Background: Tinea Capitis (TC) is a dermatophyte infection of the scalp hair follicles and intervening skin. TC is mainly caused by anthropohilic and zoophilic species of the genera Trichophyton and Microsporum. On the basis of the type of hair invasion, dermatophytes are also classified as endothrix, ectothrix or favus. Despite the availability of effective antifungal agents, dermatophytic infections continue to be one of the principal dermatological diseases in Mysore. Objectives: To study the genus and species variants, of fungus causing Tinea Capitis infection and epidemiological factors responsible for the disease in Central Mysore. Materials and methods: Clinically suspected 527 patients with dermatophytes infection cases were included in our study, where 58 cases were diagnosed and confirmed as a Tinea Capitis patients only selected for our study. Suspected lesion like scalp skin scraping and hair plucking samples were collected after disinfecting the site with 70% of ethyl alcohol. Samples were collected in a sterile thick black envelope, folded, labelled and brought to the laboratory for further processing according to slandered Mycological protocol. Results: A total of 527 patients with dermatophytes infection suspected cases were included in our study, where 58 cases (11.0%) were confirmed as a Tinea Capitis.
    [Show full text]
  • Utilization of the Internal Transcribed Spacer Regions As Molecular Targets
    Medical Mycology 2002, 40, 87±109 Accepted 9July 2001 Review article Utilizationof the internaltranscribed spacer regions as molecular targets to detect andidentify human fungal pathogens P.C.IWEN*, S.H.HINRICHS* & M.E.RUPP Downloaded from https://academic.oup.com/mmy/article/40/1/87/961355 by guest on 29 September 2021 y *Department ofPathology and Microbiology,University ofNebraska MedicalCenter, Omaha, Nebraska, USA; Internal Medicine, y University ofNebraska MedicalCenter, Omaha, Nebraska, USA Advancesin molecular technology show greatpotential for the rapiddetection and identication of fungifor medical,scienti c andcommercial purposes. Numerous targetswithin the fungalgenome have been evaluated, with much of the current work usingsequence areas within the ribosomalDNA (rDNA) gene complex. This sectionof the genomeincludes the 18S,5 8Sand28S genes which codefor ribosomal ¢ RNA(rRNA) andwhich havea relativelyconserved nucleotide sequence among fungi.It alsoincludes the variableDNA sequence areas of the interveninginternal transcribedspacer (ITS) regionscalled ITS1 and ITS2. Although not translatedinto proteins,the ITScoding regions have a criticalrole in the developmentof functional rRNA,with sequencevariations among species showing promiseas signature regionsfor molecularassays. This review of the current literaturewas conducted to evaluateclinical approaches for usingthe fungalITS regions as molecular targets. Multipleapplications using the fungalITS sequences are summarized here including those for cultureidenti cation, phylogenetic
    [Show full text]
  • DERMATOPHYTOSIS ( Ti Ri ) ( Ti Ri ) (=Tinea = Ringworm)
    DERMATOPHYTOSIS (Ti(=Tinea = Ringworm) IInfection of the skin, hair or nails caused by a group of keratinophilic fungi, called dermatophytes ¨ Microsporum Hair, skin ¨ Epidermophyton Skin, nail ¨ TTihrichoph htyton HHiair, skin, nail DERMATOPHYTES IDigest keratin by their keratinases IResistant to cycloheximide IClassified into three groups depending on their usual habitat All three dermatoppyhytes contain virulence factors that allow them to invade the skin, hair, and nails Keratinases Elastase Proteinases DERMATOPHYTES IANTROPOPHILIC Trichophyton rubrum... IGEOPHILIC Microsporum gypseum... IZOOPHILIC Microsporum canis: cats and dogs Microsporum nanum: swine Trichophyton verrucosum: horse and swine… Zoophilic dermatophytes Microscopic characteristics of dermatophyte genera Microsporum Epidermophyton Trichophyton DERMATOPHYTOSIS PhPathogenesi s and Immuni ty IContact and trauma IMoisture ICrowded living conditions ICellular immunodeficiency Æ(()chronic inf.) IReRe--infectioninfection is possible (but, larger inoculum is needed, the course is shorter ) DERMATOPHYTOSIS Clllinical Cllfassification IInfection is named according to the anatomic location involved: a. Tinea barbae e. Tinea pedis (Athlete’ s foot) b. Tinea corporis f. Tinea manuum c. Tinea capitis g. Tinea unguium d. Tinea cruris (Jock itch) DERMATOPHYTOSIS Clini ca l manifestat ions ISkin: Circular, dry, erythematous, scaly, itchy lesions IHair: Typical lesions,”kerion”, scarring, “l“alopeci i”a” INail: Thickened,,fm, deformed, friable, discolored nails, subungual debris accumulation IFavus (Tinea favosa) DERMATOPHYTOSIS TiiTransmission IClose human contact ISharing clothes, combs, brushes, towels, bedsheets... (Indirect ) IAnimalAnimal--toto--humanhuman contact (Zoophilic) DERMATOPHYTOSIS Diagnos is I. Clllinical Appearance Wood lamp (UV, 365 nm) II. Lab A. Direct microscopic examination ((1010--2525%% KOH) Ectothrix/endothrix/favic hair DERMATOPHYTOSIS Diagnos is B. Culture Mycobiotic agar Sabdbouraud dextrose agar DERMATOPHYTES Iden tifica tion A. Colony characteristics B.
    [Show full text]
  • Superficial and Cutaneous Mycoses Superficial Mycoses
    Superficial and Cutaneous Mycoses Superficial Mycoses • Limited to the outermost layer of the skin • 4 Infections – 1.Pityriasis versicolor – 2.Tinea nigra – 3. Black piedra – 4. White piedra Superficial • Do not elicit immune response • No discomfort • Cosmetic problems • Limited to stratum corneum Pityriasis Versicolor • Malassezia furfur (Pityrosporum orbiculare) • Lipophilic yeast like organism • Rich in sebaceous glands • Media is supplemented with fatty acids • Exist in budding yeast,occasionally hyphal Pityrisis versicolor (An-an) Pityriasis • Lesions are found in torso, arms and abdomen • Scale very easily chalky appearance • Rarely, papular or grow like folliculitis Pityriasis • Clinical Diagnosis: KOH- Spaghetti and meatballs • Treatment: Azoles Tinea Nigra • Exophiala werneckii • Produce melanin black or brown color • Grows as yeast Older hyphae with mycelia and conidia Tinea nigra • Lesion- gray to black macular palms • Diagnosis- Skin scrapings with alkali stain • Cultures- Sabourauds’s media pigmented yeast and hyphae Black Piedra • Piedraia hortae- exist in teleomorphic state • Cultures – asexual state - older cultures teleomorphic (asci ,which contain spindle shaped ascospores) Black piedra • Clinical feature: presence of hard nodules found along the infected hair shaft • Nodules contain asci White Piedra • Trichosporon beigelii • Grows in media without cyclohexamide • Cultures are pasty and white developed deep radiating furrows and become yellow and creamy White Piedra • Microscopic examination septate hypae that develops
    [Show full text]
  • Common Fungal Infections 13
    Chapter 13 13 Common Fungal Infections With respect to the mode of presentation and propa- 13.1.1 gation in tissue there are three categories of fungi: Clinical Appearance 1. Yeast fungi (unicellular fungi) exist only as spores Different parts of the body may be affected. With re- and produce new spores by budding. spect to the location, the eruption may have a more or 2. Filamentous fungi produce filaments (hyphae), but less characteristic appearance. This is the reason why not yeast cells. Some kinds of filamentous fungi the disease is named after the part of the body affected: form septate hyphae (i.e., the hyphae consist of a tinea corporis (includes trunk and limbs), tinea faciei, chain of cells separated by septa); other kinds pro- tinea cruris, tinea manuum, tinea pedis, tinea capitis, duce non-septate hyphae. Filamentous fungi may tinea barbae, and tinea unguium. brake up into spores called arthrospores. A con- For example, tinea circinata is the characteristic glomeration of hyphae is called mycelium. lesion usually seen in tinea corporis. It presents as a 3. Dimorphic fungi are able to form both hyphae and rounded, erythematous, slightly infiltrated, more or yeast spores. They produce new yeast cells by bud- less scaling plaque, which extends gradually at the pe- ding from spores as well as from hyphae. riphery and becomes circinate or annular due to cen- The most common kinds of fungal skin infections are tral healing. The active border is clearly defined and dermatophytosis, Malassezia furfur/pityrosporum in- slightly raised and may contain pustules. fections, candidiasis, and aspergillosis.
    [Show full text]
  • Fungal Infections
    Fungal infections Natural defence against fungi y Fatty acid content of the skin y pH of the skin, mucosal surfaces and body fluids y Epidermal turnover y Normal flora Predisposing factors y Tropical climate y Manual labour population y Low socioeconomic status y Profuse sweating y Friction with clothes, synthetic innerwear y Malnourishment y Immunosuppressed patients HIV, Congenital Immunodeficiencies, patients on corticosteroids, immunosuppressive drugs, Diabetes Fungal infections: Classification y Superficial cutaneous: y Surface infections eg. P.versicolor, Dermatophytosis, Candidiasis, T.nigra, Piedra y Subcutaneous: Mycetoma, Chromoblastomycosis, Sporotrichosis y Systemic: (opportunistic infection) Histoplasmosis, Candidiasis Of these categories, Dermatophytosis, P.versicolor, Candidiasis are common in daily practice Pityriasis versicolor y Etiologic agent: Malassezia furfur Clinical features: y Common among youth y Genetic predisposition, familial occurrence y Multiple, discrete, discoloured, macules. y Fawn, brown, grey or hypopigmented y Pinhead sized to large sheets of discolouration y Seborrheic areas, upper half of body: trunk, arms, neck, abdomen. y Scratch sign positive PITYRIASIS VERSICOLOR P.versicolor : Investigations y Wood’s Lamp examination: y Yellow fluorescence y KOH preparation: Spaghetti and meatball appearance Coarse mycelium, fragmented to short filaments 2-5 micron wide and up to 2-5 micron long, together with spherical, thick-walled yeasts 2-8 micron in diameter, arranged in grape like fashion. P.versicolor: Differential diagnosis y Vitiligo y Pityriasis rosea y Secondary syphilis y Seborrhoeic dermatitis y Erythrasma y Melasma Treatment P. versicolor Topical: y Ketoconazole , Clotrimazole, Miconazole, Bifonazole, Oxiconazole, Butenafine,Terbinafine, Selenium sulfide, Sodium thiosulphate Oral: y Fluconazole 400mg single dose y Ketoconazole 200mg OD x 14days yGriseofulvin is NOT effective.
    [Show full text]
  • Fungal Diseases of the Scalp Skin in the Trichologist Practice
    About OMICS Group OMICS Group is an amalgamation of Open Access Publications and worldwide international science conferences and events. Established in the year 2007 with the sole aim of making the information on Sciences and technology ‘Open Access’, OMICS Group publishes 500 online open access scholarly journals in all aspects of Science, Engineering, Management and Technology journals. OMICS Group has been instrumental in taking the knowledge on Science & technology to the doorsteps of ordinary men and women. Research Scholars, Students, Libraries, Educational Institutions, Research centers and the industry are main stakeholders that benefitted greatly from this knowledge dissemination. OMICS Group also organizes 500 International conferences annually across the globe, where knowledge transfer takes place through debates, round table discussions, poster presentations, workshops, symposia and exhibitions. OMICS International Conferences OMICS International is a pioneer and leading science event organizer, which publishes around 500 open access journals and conducts over 500 Medical, Clinical, Engineering, Life Sciences, Pharma scientific conferences all over the globe annually with the support of more than 1000 scientific associations and 30,000 editorial board members and 3.5 million followers to its credit. OMICS Group has organized 500 conferences, workshops and national symposiums across the major cities including San Francisco, Las Vegas, San Antonio, Omaha, Orlando, Raleigh, Santa Clara, Chicago, Philadelphia, Baltimore, United Kingdom, Valencia, Dubai, Beijing, Hyderabad, Bengaluru and Mumbai. Fungal diseases of the scalp skin in the Trichologist practice. Dr. Inga Zemite Veselibas Centrs 4 Latvia Definition of fungi The living world is divided into the five kingdoms of Planta, Animalia, Fungi, Protista and Monera. Generally speaking fungi are: eukaryotica, heterotrophic unicellular to filamentous, rigid cell walled, spore- bearing organisms that usually reproduce by both sexual and asexual means.
    [Show full text]
  • WO 2016/046523 Al 31 March 2016 (31.03.2016) P O P C T
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2016/046523 Al 31 March 2016 (31.03.2016) P O P C T (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61K 31/145 (2006.01) A61P 31/10 (2006.01) kind of national protection available): AE, AG, AL, AM, A61P 31/04 (2006.01) AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, (21) Number: International Application DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, PCT/GB20 15/0527 13 HN, HR, HU, ID, IL, IN, IR, IS, JP, KE, KG, KN, KP, KR, (22) International Filing Date: KZ, LA, LC, LK, LR, LS, LU, LY, MA, MD, ME, MG, 2 1 September 2015 (21 .09.201 5) MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, SC, (25) Filing Language: English SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, (26) Publication Language: English TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (30) Priority Data: (84) Designated States (unless otherwise indicated, for every 1416716.7 22 September 2014 (22.09.2014) GB kind of regional protection available): ARIPO (BW, GH, 62/053,505 22 September 2014 (22.09.2014) US GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, ST, SZ, TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, (71) Applicant: NOVABIOTICS LIMITED [GB/GB]; The TJ, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, Cruickshank Building, Craibstone, Aberdeen, Aberdeen DK, EE, ES, FI, FR, GB, GR, HR, HU, IE, IS, IT, LT, LU, shire AB21 9TR (GB).
    [Show full text]