Pearls in Establishing a Clinical Diagnosis: Signs and Symptoms
Johan A. Maertens, Kieren A. Marr in Diagnosis of Fungal Infections, 2007
General signs of infection, such as fever, tachycardia, and acutely toxic or chronically ill appearance, are non-specific and usually do not help point the clinician toward fungal infection as a diagnosis. Patients with disseminated candidiasis can appear quite toxic, as can individuals who have had a huge environmental exposure to an endemic mycosis and present with acute respiratory distress syndrome, but these findings are indistinguishable from those seen with bacterial infections. At the other end of the spectrum, AIDS patients with cryptococcal meningitis may have no fever and no physical findings suggesting meningitis; only a mild headache will prompt the astute clinician to perform a lumbar puncture. Orthostatic hypotension is a valuable hint to look for chronic progressive disseminated histoplasmosis with adrenal involvement causing Addison’s disease (58).
Molecular Methods for the Diagnosis of Fungal Infections
Attila Lorincz in Nucleic Acid Testing for Human Disease, 2016
A clinical diagnosis of most fungal infections must therefore rely on laboratory confirmation. Unfortunately, laboratory methods such as culture and direct microscopy that can confirm the diagnosis of many fungal diseases are insensitive. Positive culture and microscopy results can also be difficult to interpret in cases where the infecting microorganism is also a common human commensal (e.g., Candida species) or is ubiquitous in the environment (e.g., Aspergillus species). The detection of such organisms, particularly in specimens derived from nonsterile sites, may result from sample contamination rather than from infection. In contrast, the recovery from clinical materials of any of the endemic mycoses (Histoplasma capsulatum, Blastomyces dermatitidis, Coccidioides immitis and posadasii, Paracoccidioides brasiliensis, and Penicillium marneffei), that are not human commensals, is strong evidence for infection. Unfortunately, if microscopic examination of clinical materials is negative, and culture confirmation is attempted, a diagnosis may be delayed for several weeks.
Nail psoriasis
Archana Singal, Shekhar Neema, Piyush Kumar in Nail Disorders, 2019
Confirming a diagnosis of nail psoriasis purely on clinical grounds can be quite challenging because of numerous overlaps with other nail dystrophies. Common differentials to be considered include: Onychomycosis (OM): Some of the nail changes of psoriasis, especially subungual hyperkeratosis and onycholysis, are in common with OM. However, the subungual hyperkeratosis in OM is usually friable in comparison with that of psoriasis (compact hyperkeratosis) and is often accompanied by white/brown/black nail plate discoloration. The important clinical differentiating points between psoriasis and OM have been summarized in Table 13.2. OM and nail psoriasis are also known to co-exist and were reported to be 47% in an Indian study.4 This highlights the importance of ruling out concomitant fungal infection prior to treatment. The salient features of OM in psoriatic nails have been summarized in Box 13.1.
Identification of a novel SPT inhibitor WXP-003 by docking-based virtual screening and investigation of its anti-fungi effect
Published in Journal of Enzyme Inhibition and Medicinal Chemistry, 2021
Xin Wang, Xin Yang, Xin Sun, Yi Qian, Mengyao Fan, Zhehao Zhang, Kaiyuan Deng, Zaixiang Lou, Zejun Pei, Jingyu Zhu
Fungal infection is one of main infectious diseases in clinic, including common superficial and invasive fungal infection1. In the past few decades, morbidity and mortality caused by invasive fungal infection have been increasing with the sharp growing immunocompromised individuals, such as patients after organ transplant, patients in ICU (morbidity up to 29%, mortality up to 49%)2,3. Due to the increasing life-threatening caused by fungal infection, the effective treatments for fungal disease are needed. However, the approved antifungal agents are quite limited, mainly containing polyenes (e.g. amphotericin B and its derivatives), azoles (e.g. fluconazole, ketoconazole), echinocandins (e.g. micafungin) and 5-fluorocytosine4. With the extensive use of conventional antifungal agents, the emerging azole-resistant fungi make the problem more intractable5–7. Moreover, the current antifungal agents always show low efficacy on killing fungal cells and high toxicity because of the similarities between fungi and mammals. Therefore, developing novel antifungal agents against new targets is urgent need to improve the efficacy in killing fungi and decrease the side effects8.
Formulation and evaluation of butenafine loaded PLGA-nanoparticulate laden chitosan nano gel
Published in Drug Delivery, 2021
Sultan Alshehri, Syed Sarim Imam
The topical delivery system is the most common route of administration for active therapeutics for the treatment of various skin diseases. The fungal infection can be caused by different micro-organisms like Candida, Aspergillus, and Blastomyces. There are different types of skin infections reported by these organisms. The infection caused by candida occurs between skin folds and where the heat and moisture lead to maceration as well as inflammation. In the case of Aspergillus, it mainly affects the person having low immunity. Aspergillosis infection found in few patients (5–10%) causes skin lesions. The lesions include single or multiple red or violet hardened plaques or papules. The key task for topical preparation is the penetration of the drug through the first layer of skin (stratum corneum) to reach the required therapeutic concentration to produce the pharmacological action (Mali et al., 2017; El-Housiny et al., 2018).
Perillaldehyde Protects Against Aspergillus fumigatus Keratitis by Reducing Fungal Load and Inhibiting Inflammatory Cytokines and LOX-1
Published in Current Eye Research, 2022
Mengting He, Jia You, Xing Liu, Xudong Peng, Cui Li, Shanshan Yang, Qiang Xu, Jing Lin, Guiqiu Zhao
Perillaldehyde (PAE) is the main component of essential oil derived from perilla plant (Perilla frutescens), which has valued us due to its extensive antifungal, anti-inflammatory functions in fighting against infectious diseases.6 Both fungal virulence factors and excessive inflammation can lead to corneal tissue damage.7 Fungal infections include the adhesion to host cells, the growth of hyphae, and the formation of biofilm, which lead to the invasion of fungi and the aggravation of diseases.8–10 Researches revealed that PAE was able to inhibit the growth of Candida albicans (C. albicans) in vitro and it could also interfere with ergosterol biosynthesis, which can lead to the destruction of biofilm of Aspergillus niger.11–13 Our previous studies also verified that PAE had an inhibitory effect on the growth of A. fumigatus14. In addition, the excessive secretion of inflammatory cytokines in FK can exacerbate corneal damage.15 In latest studies, PAE was confirmed to decrease the number of immune cells like neutrophils and macrophages in mice infected with C. albicans and alleviate the overexpression of inflammatory factors in cerebral ischemia–reperfusion injury.16,17
Related Knowledge Centers
- Infection
- Pathogenic Fungus
- Subcutaneous Tissue
- Dermatophytosis
- Tinea Corporis
- Tinea Cruris
- Tinea Manuum
- Athlete'S Foot
- Tinea Barbae
- Tinea Versicolor