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The symptoms of fungal keratitis are blurred vision, a red and painful eye that does not improve when contact lenses are removed, or on antibiotic treatment, increased sensitivity to light (photophobia), and excessive tearing or discharge. The symptoms are markedly less as compared to a similar bacterial ulcer.
Signs: The eyelids and adnexa involved shows edema and redness, conjuctiva is chemosed. Ulcer may be present. It is a dry looking corneal ulcer with satellite lesions in the surrounding cornea. Usually associated with fungal ulcer is hypopyon, which is mostly white fluffy in appearance. Rarely, it may extend to the posterior segment to cause endophthalmitis in later stages, leading to the destruction of the eye. (Note: Fungal endophthalmitis is extremely rare)
Infectious keratitis can be bacterial, fungal, viral, or protozoal. Remarkable differences in presentation of the patient allows presumptive diagnosis by the eye care professional, helping in institution of appropriate anti-infective therapy.
Primary infection most commonly manifests as blepharoconjunctivitis i.e. infection of lids and conjunctiva that heals without scarring. Lid vesicles and conjunctivitis are seen in primary infection. Corneal involvement is rarely seen in primary infection.
The initial trauma causing the infection is often forgotten or not noticed. The infection builds at the site over a period of years, and a small red papule (skin elevation) appears. The lesion is usually not painful, with few, if any symptoms. Patients rarely seek medical care at this point.
Several complications may occur. Usually, the infection slowly spreads to the surrounding tissue while still remaining localized to the area around the original wound. However, sometimes the fungi may spread through the blood vessels or lymph vessels, producing metastatic lesions at distant sites. Another possibility is secondary infection with bacteria. This may lead to lymph stasis (obstruction of the lymph vessels) and elephantiasis. The nodules may become ulcerated, or multiple nodules may grow and coalesce, affecting a large area of a limb.
This classic herpetic lesion consists of a linear branching corneal ulcer (dendritic ulcer). During eye exam the defect is examined after staining with fluorescein dye. The underlying cornea has minimal inflammation.
Patients with epithelial keratitis complain of foreign-body sensation, light sensitivity, redness and blurred vision.
Focal or diffuse reduction in corneal sensation develops following recurrent epithelial keratitis.
In immune deficient patients or with the use of corticosteroids the ulcer may become large and in these cases it is called geographic ulcer.
The most common finding on ear examination is the presence of greyish white thick debris and heaviness in the ear.
Mycoses are classified according to the tissue levels initially colonized.
Superficial mycoses are limited to the outermost layers of the skin and hair.
An example of such a fungal infection is "Tinea versicolor", a fungus infection that commonly affects the skin of young people, especially the chest, back, and upper arms and legs. "Tinea versicolor" is caused by a fungus that lives in the skin of some adults. It does not usually affect the face. This fungus produces spots that are either lighter than the skin or a reddish brown. This fungus exists in two forms, one of them causing visible spots. Factors that can cause the fungus to become more visible include high humidity, as well as immune or hormone abnormalities. However, almost all people with this very common condition are healthy.
It is a characterized by a breakdown or damage of the epithelium of the cornea in a pinpoint pattern, which can be seen with examination with a slit-lamp. Patients may present with non-specific symptoms such as red eye, tearing, foreign body sensation, photophobia and burning.
There may be loss of hair as hair will come out easily. Sometimes, there is growth of organisms. Lymph and fever symptoms may be present. This condition can be mistaken for a case of impetigo.
Mucormycosis frequently infects the sinuses, brain, or lungs. While infection of the oral cavity or brain are the most common forms of mucormycosis, the fungus can also infect other areas of the body such as the gastrointestinal tract, skin, and other organ systems. In rare cases, the maxilla may be affected by mucormycosis. The rich blood vessel supply of maxillofacial areas usually prevents fungal infections, although more virulent fungi, such as those responsible for mucormycosis, can often overcome this difficulty.
There are several key signs which point towards mucormycosis. One such sign is fungal invasion into the blood vessels which results in the formation of blood clots and surrounding tissue death due to a loss of blood supply. If the disease involves the brain, then symptoms may include a one-sided headache behind the eyes, facial pain, fevers, nasal congestion that progresses to black discharge, and acute sinusitis along with eye swelling. Affected skin may appear relatively normal during the earliest stages of infection. This skin quickly becomes reddened and may be swollen before eventually turning black due to tissue death. Other forms of mucormycosis may involve the lungs, skin, or be widespread throughout the body; symptoms may also include difficulty breathing, and persistent cough. In cases of tissue death, symptoms include nausea and vomiting, coughing up blood, and abdominal pain.
Corneal ulcers are extremely painful due to nerve exposure, and can cause tearing, squinting, and vision loss of the eye. There may also be signs of anterior uveitis, such as miosis (small pupil), aqueous flare (protein in the aqueous humour), and redness of the eye. An axon reflex may be responsible for uveitis formation—stimulation of pain receptors in the cornea results in release inflammatory mediators such as prostaglandins, histamine, and acetylcholine.
Sensitivity to light (photophobia) is also a common symptom of corneal ulcer.
Otomycosis is a fungal ear infection, a superficial mycotic infection of the outer ear canal. It is more common in the tropical countries. The infection may be either subacute or acute and is characterized by malodorous discharge, inflammation, pruritus, scaling, and severe discomfort. Suppuration can occur due to superimposed bacterial infection commonly due to pseudomonas species and proteus species. The mycosis results in inflammation, superficial epithelial exfoliation, masses of debris containing hyphae, suppuration, and pain.
Individuals with the condition of fungal sinusitis mostly present with features that include facial pain and pain around the eyes, nasal congestion, rhinorrhea(running nose), headache, later there may be ophthalmoplegia (paralysis of ocular muscles).
"Acanthamoeba" infection is a cutaneous condition resulting from "Acanthamoeba" that may result in various skin lesions. "Acanthamoeba" strains can also infect human eyes causing acanthamoebic keratitis.
The most common symptom of a fungal nail infection is the nail becoming thickened and discoloured: white, black, yellow or green. As the infection progresses the nail can become brittle, with pieces breaking off or coming away from the toe or finger completely. If left untreated, the skin underneath and around the nail can become inflamed and painful. There may also be white or yellow patches on the nailbed or scaly skin next to the nail, and a foul smell. There is usually no pain or other bodily symptoms, unless the disease is severe. People with onychomycosis may experience significant psychosocial problems due to the appearance of the nail, particularly when fingers – which are always visible – rather than toenails are affected.
Dermatophytids are fungus-free skin lesions that sometimes form as a result of a fungus infection in another part of the body. This could take the form of a rash or itch in an area of the body that is not infected with the fungus. Dermatophytids can be thought of as an allergic reaction to the fungus.
Chromoblastomycosis (also known as chromomycosis, cladosporiosis, Fonseca's disease, Pedroso's disease, phaeosporotrichosis, or verrucous dermatitis) is a long-term fungal infection of the skin and subcutaneous tissue (a chronic subcutaneous mycosis). The infection occurs most commonly in tropical or subtropical climates, often in rural areas. It can be caused by many different types of fungi which become implanted under the skin, often by thorns or splinters. Chromoblastomycosis spreads very slowly; it is rarely fatal and usually has a good prognosis, but it can be very difficult to cure. The several treatment options include medication and surgery.
Ulcerative dermatitis is a skin disorder in rodents associated with bacterial growth often initiated by self-trauma due to a possible allergic response. Although other organisms can be involved, bacteria culture frequently shows Staphylococcus aureus. Primarily found on the rib cage, neck, and shoulder, lesions are often irregular, circumscribed, and moist. Intense itching may lead to scratching which may aggravate and perpetuate the lesion. Destruction of the epidermis along with underlying pustules or abscesses, and granulomatous inflammation, may be present.
In cases where topical treatment alone does not resolve the dermatitis and irritants are not known, a secondary bacterial, fungal or yeast infection might be present and may require an anti-fungal or antibiotics to be prescribed by the veterinarian to affect a cure.
In rats, this skin disorder may be observed on the neck and head, often secondary to skin trauma from scratches or fighting.
Corneal ulcer, or ulcerative keratitis, is an inflammatory or more seriously, infective condition of the cornea involving disruption of its epithelial layer with involvement of the corneal stroma. It is a common condition in humans particularly in the tropics and the agrarian societies. In developing countries, children afflicted by Vitamin A deficiency are at high risk for corneal ulcer and may become blind in both eyes, which may persist lifelong. In ophthalmology, a corneal ulcer usually refers to having an infectious cause while the term corneal abrasion refers more to physical abrasions.
The initial lesion is a small subcutaneous swelling following minor trauma. Later, sinuses that discharge purulent and seropurulent exudates containing grains which are fungal colonies are formed. Destruction of deeper tissues, and deformity and loss of function in the affected limbs may occur in later stages.
Onychomycosis, also known as tinea unguium, is a fungal infection of the nail. This condition may affect toenails or fingernails, but toenail infections are particularly common.
Treatment may be based on the signs. Treatment may be with the medication terbinafine.
It occurs in about 10 percent of the adult population. It is the most common disease of the nails and constitutes about half of all nail abnormalities.
The term is from Ancient Greek ὄνυξ "ónux" "nail", μύκης "múkēs" "fungus" and -ωσις "ōsis" "functional disease."
Kerion is the result of the host's response to a fungal ringworm infection of the hair follicles of the scalp (occasionally the beard) that can be accompanied by secondary bacterial infection(s). It usually appears as raised, spongy lesions, and typically occurs in children. This honeycomb is a painful inflammatory reaction with deep suppurative lesions on the scalp. Follicles may be seen discharging pus. There may be sinus formation and rarely mycetoma-like grains are produced. It is usually caused by dermatophytes (fungal infections of the skin affecting humans and animals) such as "Trichophyton verrucosum", "T. mentagrophytes", and "Microsporum canis". Treatment with oral griseofulvin common.
Punctate epithelial erosions is a pathology affecting the cornea. It is also known as punctate erosive keratopathy or superficial punctate keratitis.
The mechanism of fungal sinusitis depends on which form, such as:
- "Acute fulminant form" – the fungus invades into vessels causing thrombosis, necrosis with minimum inflammation
- "Chronic invasive" – fungal hyphae invades tissue leaving necrosis with minimal inflammation
- "Granulomatous form" – invasive hyphae invades tissue with inflammation and non-caseating granuloma (with foreign bodies).
- "Saprophytic infection" – growth of fungus seen on mucous crusts within sinus cavity.
- "Sinus fungal ball" – sequestration of fungal hyphae as densely tangled, and has "gritty matted" appearance.
- "Eosinophil related Allergic fungal sinusitis" – though not completely understood, a possible mechanism sees the protein component of fungus elicits IgE mediated allergic mucosal inflammation.
Mucormycosis is any fungal infection caused by fungi in the order Mucorales. Generally, species in the "Mucor," "Rhizopus," "Absidia", and "Cunninghamella" genera are most often implicated.
The disease is often characterized by hyphae growing in and around blood vessels and can be potentially life-threatening in diabetic or severely immunocompromised individuals.
"Mucormycosis" and "zygomycosis" are sometimes used interchangeably. However, zygomycota has been identified as polyphyletic, and is not included in modern fungal classification systems. Also, while zygomycosis includes Entomophthorales, mucormycosis excludes this group.