Fungi are one of the infectious agents that can infect the body causing sickness. They can affect any part of the body whether external or internal. But the most visible and common manifestation is infection of the skin. Spores of fungi are like seeds of plants and are present in the atmosphere. They can enter the body through any possible route. Athlete’s foot is a fungal infection of the sole or toes. It can occur due to walking about bare footed and or exposed to dampness. It can come from swimming pools and sauna baths. Wearing socks damp with sweat for long hours makes one susceptible to athlete’s foot. There is intense intermittent itching and white discoloration on sole or between toes. Untreated, slowly it spreads to other toes causing aggravation of symptoms. Scalp can be affected during hair cut due to contaminated scissors being used from one client to another. Superficial fungal infection can be anywhere on the skin but moist areas like axilla, breasts, groin, genital parts are more prone due to dampness. There is white or light coloured rashes which tend to flake off. These flakes disperse spores in the environment tending to infect others. These infections are usually localised, but in immune-depressed people such as those with HIV/Aids, there is extensive infection involving entire skin. Fungal infections involving the nails cause black discoloration of the nails which is otherwise symptom free. Mouth may be involved internally leading to painful swallowing and talking. If the ear is affected there is intense itching inside or outside the ear, depending on the site affected. Scratching results in secondary bacterial infections. Thus pain and purulent secretions are added to the already existing problem. Fungal spores can enter lungs through nose and produce features similar to pneumonia and tuberculosis. Heart failure can be produced due to involvement of the layers of the heart. Esophageal or pharyngeal involvement leads to painful swallowing. Fungal infections of the internal organs usually occur in immune depressed states where body’s immunity goes down as in HIV/Aids, chronic renal failure, diabetes, among others. Even the brain is not spared. Its substance and covers (meninges) can be affected by various kinds of fungal infections causing loss of consciousness, paralysis, convulsions, etc problems. Prolonged antibiotic or corticosteroid use can lead to fungal infections. Fungal infection of the visible parts of the body like skin, mouth, genitals, among others, is easy to diagnose due to its characteristic appearance. Diagnosis is confirmed by examination of the smear from affected part under the microscope. Difficulty comes in diagnosing the infection of the internal body parts because it mimics many other diseases. It needs a high degree of suspicion. Signs of presence of fungus anywhere on the body give a clue to the nature of infection in such cases. These infections are entirely preventable. One should always keep all body parts clean and dry, because moisture predisposes to fungal infections. Underwear and socks of synthetic material should be shunned and replaced by cotton material because nylon does not allow skin to “ breathe”. If one has been infected already, a prolonged treatment is needed to eradicate the infection. For example, infection of under arms or genitals would need four to six weeks of treatment, whereas that of nails would require about nine months. There are antifungal tablets, ointments and dusting powders available for eradicating the infection. A person has to follow his physician’s decision regarding the mode of treatment to be taken. A word of caution; whatever treatment taken will clear the present problem but if precautions are not taken, re-infection can occur easily in susceptible conditions. Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital
