There are many infectious agents in the atmosphere ready to affect man once his immunity fails to overcome the dose of infecting agent. Infection by fungi is one category of infectious illness causing chronic sickness. Fungal infections 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 remain disseminated in the atmosphere. Given a chance they can enter the body through any point where they find entry. Athlete’s foot is a fungal infection of the sole or toes. It can come due to walking about bare footed and exposure to dampness. It is not only poor people but the rich too who can be affected. It can come from swimming pools and sauna baths. Wearing socks damp with sweat for long hours also makes one susceptible to athlete’s foot. It causes intense intermittent itching and white discoloration on sole or between toes. Untreated, slowly it spreads to other toes and or greater part of soles causing aggravation of symptoms. Such type of 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, discoloured rashes which tend to flake off. These flakes disperse spores in the environment tending to infect other people. In otherwise healthy persons these infections are usually localized. But in immune depressed people like HIV/AIDS patients there is extensive infection involving entire skin. Fungal infections involving the nails cause black discoloration of the nails which is otherwise symptom free. The mouth may be involved internally leading to painful swallowing and talking. If the ear is affected, there is intense itching inside or outside it, depending on the site affected. One tends to scratch there resulting 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 clinical features similar to pneumonia and tuberculosis. Heart failure can be produced due to involvement of the layers of the heart. Infection of Esophageal or pharyngeal leads to painful swallowing. Fungal infections of the internal organs usually occur in immune depressed states where the body’s immunity goes down as in HIV/AIDS, chronic renal failure, diabetics or cancer patients. Even the brain is not spared as it’s substance and covers (meninges) can be affected by various kinds of fungal infections causing loss of consciousness, paralysis, convulsions and a host of other problems. Prolonged antibiotic or corticosteroid use can also lead to fungal infections. Women are more prone to genital fungal infections due to the dampness produced during menstrual cycles. Workers at construction sites, cultivators, people involved in washing and cleaning, babies and toddlers wearing wet diapers for long, are all susceptible to developing fungal infections. Fungal infection of the external visible parts of the body like skin, mouth, genitals, e.t.c. 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 already been infected, a prolonged treatment is needed to eradicate the infection. Because superficial infection may subside in 1 to 2 weeks but spores or filaments present in deeper layers of skin tend to germinate again under favourable circumstances. For example infection of under arms or genitals would need 4 to 6 weeks of treatment whereas that of nails would require about 9 months. There are antifungal tablets, ointments and dusting powders available for eradicating the infection. A person has to follow the 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 easily occur in susceptible conditions. rachna212002@yahoo.co.uk
