The clinical type and etiological agents of superficial dermatophytosis: A cross sectional study

2021 ◽  
Vol 7 (4) ◽  
pp. 331-336
Author(s):  
Sushmita Agrahari ◽  
Shivam ◽  
Shitij Goel ◽  
Gopi Krishna Maddali
Keyword(s):  
Fungal Infections ◽  
Trichophyton Mentagrophytes ◽  
Common Species ◽  
Fungal Species ◽  
Tinea Corporis ◽  
Fungal Culture ◽  
Tinea Cruris ◽  
Direct Microscopy ◽  
Clinical Type ◽  
Keratinized Tissue

Dermatophytosis are fungal infections caused by three genera of fungi that have the unique ability to invade and multiply within keratinized tissue (hair, skin, and nails). Although dermatomycoses are globally distributed, the endemic and most prevalent species of dermatophytosis differ strikingly from one geographic locality to another. Changing trend has been noticed in last few years with dermatophytic infections presenting as chronic, treatment unresponsive and recurrent. Also various microscopic and fungal culture studies have shown shift in identification of causative fungal species in recent years. Numerous studies have been done on the occurrence of dermatophytes in various parts of our country illustrating the range and changing pattern of fungal infection as well as causative fungal species. Total number of 150 patients attending outpatient department of our hospital who were clinically diagnosed as having superficial dermatophytosis were enrolled into the study. Patients were carefully screened as per inclusion and exclusion criteria and then enrolled in the study. Samples were taken from all the patients and examined for KOH direct microscopy and sent for fungal culture on Sabouraud’s Dextrose Agar as well as on Dermtophyte Test Medium. Results were then analyzed using standard statistical methods. Out of total 150 patients, 101 were males and 49 were females. Most common age group was 21-30 years (37.3%). 58 patients (38.7%) showed positivity to KOH microscopy as well as fungal culture. Additionally 25 more samples demonstrated positivity to KOH microscopy (total 83 patients) but negativity to culture, while 9 patient samples were positive to culture but negative to direct microscopy. Predominant fungal species isolated on culture was Trichophyton mentagrophytes (50.7%) while next common species isolated was T. tonsurans (29.9%). No significant association was found between dermatophyte isolate on culture and clinical type. Trichophyton mentagrophytes and Trichophyton tonsurans were the most common species isolated among subjects with Tinea faciei, Tinea cruris and Tinea corporis. The study showed a male preponderance and T. corporis was the commonest clinical type found. Majority of patients were in the 3rd decade and came within a duration of 1 month to 6 months of getting an infection. In patients diagnosed with tinea corporis, tinea cruris, tinea pedis and tinea manuum, T. mentagrophytes was the most predominant species isolated.

scholarly journals A clinical and mycological study of superficial mycosis

2021 ◽  
Vol 7 (2) ◽  
pp. 192
Author(s):  
Suma Patil ◽  
Dayanand Raikar
Keyword(s):  
Age Groups ◽  
Clinical History ◽  
Trichophyton Mentagrophytes ◽  
Common Species ◽  
Human Infection ◽  
Tinea Corporis ◽  
Fungal Culture ◽  
Sample Collection ◽  
Tinea Cruris ◽  
Superficial Mycosis

<p><strong>Background: </strong>Superficial mycosis is among the most frequent forms of human infection affecting more than 20-25% of world’s population. Current study aims at assessing the clinical profile of dermatophytic infection and to identify the fungal species responsible. <strong></strong></p><p><strong>Methods: </strong>A prospective study conducted on 100 patients with clinically suspected dermatophytosis presenting to Skin OPD in a tertiary hospital in north Karnataka. A detailed clinical history, general physical examination and systemic examination routine lab investigations were done. Sample collection for mycological examinations was done for direct microscopy in 10% KOH (40% KOH for nail) and fungal culture an SDA with 0.5% chloramphenicol and 0.5% cyclohexidine was done in every case.<strong></strong></p><p><strong>Results: </strong>A total of 100 patients were included in the study. Male:female ratio was approximately 3:2. Maximum numbers of cases were in the age groups of 16-30 years (46 cases). 46% patients had multiple site involvement followed by tinea corporis in 20 (20%), tinea cruris in 18 (18%), tinea unguium (8%), tinea manuum (3%), tinea pedis (3%), tinea barbae (1%), and tinea faciei (1%). Potassium hydroxide examination was positive for fungal elements in 88(88%) patients and 35(35%). The most common species identified were. <em>Trichophyton rubrum</em> in 60% samples, followed by <em>Trichophyton mentagrophytes </em>in 20%.</p><p><strong>Conclusions:</strong> Present clinical and mycological study showed tinea corporis as the most common clinical pattern followed by tinea cruris and <em>T. rubrum</em> as the most common causative agent.</p>

scholarly journals “Epizoonosis of Dermatophytosis”: A Clinico - Mycological Study of Dermatophytic Infections in Central Nepal

2012 ◽  
Vol 10 (1) ◽  
pp. 20-23 ◽  
Author(s):  
M Mathur ◽  
SK Kedia ◽  
RBK Ghimire
Keyword(s):  
Fungal Species ◽  
Tinea Corporis ◽  
Female Dominance ◽  
Trichophyton Verrucosum ◽  
Dermatology Department ◽  
Direct Microscopy ◽  
Male Predominance ◽  
Central Nepal ◽  
Clinical Type ◽  
Number Of Patients

Background Identification of dermatophytic species in clinical settings are important not only for epidemiological but also for the treatment. Objectives Present study was carried out to find out the clinical variants of Dermatophytosis and species of fungus responsible for the disease. Methods The prospective observational analysis of 200 clinically suspected cases of dermatophytic infection attending Dermatology department of College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan, Nepal. Skin scraping, hair and nail samples were collected and processed according to standard protocol. Results Maximum number of patients enrolled in study were reported for treatment 5-8 weeks after the onset of disease. Overall male predominance was observed and ages between 26-30 years. Tinea corporis was the most common clinical type of tinea with female dominance in our study. 10 % of cases were having extensive Tinea. 71.5% of samples were positive on direct microscopy and 62 % positive on culture. Samples from T capitis were highest positive by direct microscopy (80%) and over all dominant species of fungus isolated in our study was Trichophyton verrucosum (30.6%). Conclusions The study highlighted Tinea corporis as the most common clinical type with female predominance. Overall predominant causative fungal species isolated was Trichophyton verrucosum. KATHMANDU UNIVERSITY MEDICAL JOURNAL  VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 30-33DOI: http://dx.doi.org/10.3126/kumj.v10i1.6910

scholarly journals Clinicomycological evaluation of dermatophytosis at tertiary care hospital in central India

2018 ◽  
Vol 4 (3) ◽  
pp. 409
Author(s):  
Shyam Govind Rathoriya ◽  
Ankit Kumar Jain ◽  
Kavita A. Shinde
Keyword(s):  
Fungal Infections ◽  
Tertiary Care ◽  
Age Groups ◽  
Central India ◽  
Common Species ◽  
Tinea Corporis ◽  
Valuable Insight ◽  
Care Hospital ◽  
Cross Sectional ◽  
Tinea Cruris

<p class="abstract"><strong>Background:</strong> Dermatophytoses are the infection of keratinized tissues such as the epidermis, hair, and nails caused by a group of closely related filamentous fungi known as dermatophytes.</p><p class="abstract"><strong>Methods:</strong> It was a hospital based cross-sectional study. A total number of 150 clinically diagnosed cases of skin, hair and nail infections were randomly selected from all the age groups and of both the sexes, attending Dermatology Outpatient department of CMCH, Bhopal from January 2016-December 2017.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of total 150 subjects, most common clinical type of dermatophytosis, identified in our study, was tinea corporis in 53 (35.3%) subjects followed by tinea cruris in 34 (22.6%) subjects. 134 (89.3%) subjects were tested positive by direct microscopy (KOH mount) and 69 (46.0%) by culture. Highest KOH mount positivity was seen in patient suffering from tinea corporis (94.3%) followed by tinea cruris (94.1%). Culture positivity was highest with tinea corporis (54.7%) followed by tinea lesions on more than one site (47.3%) and tinea cruris (47.0%). In our study, total 69 culture positive samples were isolated and the most common species isolated was T. rubrum in 41 (59.42%) cases.</p><p><strong>Conclusions:</strong> The present study gives valuable insight regarding clinical and mycological pattern of superficial fungal infections in this region as well as shows the importance of mycological examination of dermatophytosis samples for planning effective management. </p>

scholarly journals Clinico-mycological study and comparison of efficacy of three different techniques of sample collection from skin lesions for potassium hydroxide mount preparation in dermatophytoses

2019 ◽  
Vol 5 (1) ◽  
pp. 88 ◽  
Author(s):  
Veena Thimmappa ◽  
Veeranna Shastry ◽  
Jayadev Betkerur
Keyword(s):  
Fungal Infections ◽  
Tertiary Care ◽  
Skin Surface ◽  
Skin Lesions ◽  
Tinea Corporis ◽  
Alternative Methods ◽  
Care Hospital ◽  
Sample Collection ◽  
Direct Microscopy ◽  
Keratinized Tissue

<p class="abstract"><strong>Background:</strong> Dermatophytoses are superficial fungal infections which invade and multiply within keratinized tissue. The KOH mount is one of the useful procedures and believed to be more reliable than culture for demonstrating dermatophytes. A few studies in the past have demonstrated the usefulness of alternative methods of sample collection for KOH preparation, but data on sensitivity and specificity of these methods is lacking. The aim of the study was to study the clinic-mycological aspects of dermatophytoses and to compare the efficacy of three different sampling techniques from skin lesions and correlating KOH mount with culture results.</p><p class="abstract"><strong>Methods:</strong> 210 clinically diagnosed patients with dermatophytic infection attending outpatient department of Dermatology of a tertiary care hospital for duration of 2 years (September 2015 to October 2017) were included. The samples were collected from skin, hair and nail. These samples were used for direct microscopy by KOH mount and fungal cultures by Sabouraud dextrose agar media.<strong></strong></p><p class="abstract"><strong>Results:</strong> Of the total of 210 patients, maximum were in age group of &lt;10 years (74 cases), male: female - 1.2:1. Tinea corporis was commonest presentation (40.5%). Overall direct microscopy positivity was 81% while three different techniques from the glabrous skin and groins lesions was scraping method (97%), cellophane tape method (96%), skin surface biopsy (SSB) (98%) and culture in (89%). <em>T. rubrum</em> was commonest species isolate (37.7%).</p><p class="abstract"><strong>Conclusions:</strong> Tinea corporis was the commonest clinical type followed tinea capitis. <em>T. rubrum</em> were commonest dermatophytes isolated. All three methods of sampling were suitable for routine sample collection. The KOH mount helped rapid confirmation of clinical diagnosis.</p>

Effectiveness of Homoeopathy in Tinea corporis and Tinea cruris – A Prospective, Longitudinal Observational Study

2021 ◽  
Vol 10 (1) ◽  
pp. 618-627
Author(s):  
Yogeshwari Gupta ◽  
◽  
Sonia Tuteja ◽  
Ankita Acharya ◽  
Vikrant Tripathi ◽  
...  
Keyword(s):  
Observational Study ◽  
Fungal Infection ◽  
Clinical Symptom ◽  
Fungal Infections ◽  
Tinea Corporis ◽  
P Value ◽  
Tinea Cruris ◽  
Longitudinal Observational Study ◽  
Before And After ◽  
Prospective Longitudinal

Dermatophytoses refers to superficial fungal infection of keratinized tissues caused by keratinophilic dermatophytes. According to observations worldwide, dermatophytoses are the most common of the superficial fungal infections. It is common in tropics and may present in epidemic proportions in areas with high rates of humidity. This prospective, longitudinal, observational study was conducted at SKHMC, Jaipur for a period of 1 year (April 2018 to March 2019), aiming to ascertain the effectiveness of homoeopathic medicines in the treatment of Tinea corporis and Tinea cruris. In this study, 65 cases of Tinea Infection (33 cases of Tinea cruris & 32 cases of Tinea corporis) were treated with homoeopathic medicines prescribed on the basis of totality of the symptoms. Treatment outcomes were assessed using Clinical Symptom Score, designed for this study & approved by Institutional Ethical Committee. Out of 65 patients, 41 patients (63.1%) got improved; 19 patients (29.2%) were at status quo and 05 patients (07.7%) became worse. Maximum patients were found to be in the age group of 11-40 years (n=50; 76.9%). Males were observed to be affected more as compared to females. Paired t-test was conducted on the Clinical Symptom Scores obtained before and after treatment and the result showed that p value is < 0.05 & value of t (11.623) is greater than the tabulated value in t-table at df = 64 (1.997), which was statistically significant and which also concluded that homoeopathic medicines were effective in treating Tinea corporis and Tinea cruris. Keywords Homeopathy; Dermatophytoses; Fungal infection; Observational study

Systemic Acremonium species infection in a dog

2016 ◽  
Vol 44 (06) ◽  
pp. 424-428 ◽  
Author(s):  
Kathrin Geisweid ◽  
Katrin Hartmann ◽  
Johannes Hirschberger ◽  
Monir Majzoub ◽  
Bianka Schulz ◽  
...  
Keyword(s):  
Lymph Node ◽  
Susceptibility Testing ◽  
Fungal Infections ◽  
Systemic Infection ◽  
Abdominal Ultrasound ◽  
Fungal Species ◽  
Urine Specific Gravity ◽  
Fungal Culture ◽  
Potential Threat ◽  
Neurological Signs

SummaryA 2-year-old female Magyar Viszla was referred with fever, lethargy, polyuria/polydipsia, and suspected systemic cryptococcosis. At presentation increased rectal temperature and enlarged lymph nodes were detected. Main laboratory abnormalities included lymphocytosis, eosinophilia, and mildly reduced urine specific gravity. Abdominal ultrasound was unremarkable. Lymph node cytology revealed mycotic infection. Acremonium species was isolated from urine as well as from a popliteal lymph node by fungal culture. Therapy with itraconazol (10 mg/kg p. o. q 12 h) was initiated based on susceptibility testing, but dosage had to be reduced by half due to adverse effects. Despite treatment, the dog developed progressive azotemia. Four months after initial presentation, the patient showed anorexia, lethargy, weight loss, diarrhea, vomitus, neurological signs, and severe azotemia and was euthanized. Acremonium species are emerging opportunistic mould fungi that can represent a potential threat for immunocompromised humans. In dogs, only two cases of systemic infection with this fungal species have been reported so far. This case highlights the fact that systemic fungal infections should be considered as a differential in cases of fever and lymphadenopathy.

scholarly journals A comparative trial between the therapeutic efficacy of topical 2% sertaconazole cream and 1% terbinafine cream in the treatment of tinea cruris/tinea corporis

2017 ◽  
Vol 3 (1) ◽  
pp. 59
Author(s):  
Sumyuktha J. ◽  
Murali Narasimhan ◽  
Parveen Basher Ahamed
Keyword(s):  
Comparative Trial ◽  
Treated Group ◽  
Tinea Corporis ◽  
Fungal Culture ◽  
Tinea Cruris ◽  
Complete Cure ◽  
Group A ◽  
Clinically Significant ◽  
Group B ◽  
Cure Rates

<p class="abstract"><strong>Background:</strong> Skin infections caused by dermatophyte fungi account for 6% of dermatology consultations at our hospital and 3 to 4% worldwide. A variety of antifungal agents are available for topical use. Terbinafine 1% cream is considered the first line topical medication in the treatment of dermatophytosis. Sertaconazole 2% cream is a relatively new drug having antifungal as well as antiflammatory property. In this prospective study we sought to compare the safety and efficacy of topical 2% Sertaconazole and 1% Terbinafine creams in the treatment of localized tinea cruris and/or tinea corporis<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> In this study, 80 patients were randomized into two groups of 40 each. Group A received 2% Sertaconazole cream while group B received Terbinafine 1% cream topical application twice daily for 4 weeks. Patients were followed up at the end of 2<sup>nd</sup> and 4<sup>th</sup> weeks for clinical, mycological (KOH mount and fungal culture) and complete cure (both clinical and mycological).<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of the patients studied was 27.97 years. Complete cure was achieved in 59.5% and 80% in group A and 71.4% and 90.9% in group B at the end of 2<sup>nd</sup> and 4<sup>th</sup> weeks respectively. Significant P values were observed if the results were compared within the group, between baseline and 2 weeks, baseline and 4<sup>th</sup> week and also 2<sup>nd</sup> and 4<sup>th</sup> week. Clinically significant side effects were not observed in both the groups<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Although higher cure rates were observed in the Terbinafine treated group, the results were not statistically significant. It can be concluded from our study that Sertaconazole 2% cream is similar in efficacy to Terbinafine 1% cream in the treatment of localized tinea cruris and corporis<span lang="EN-IN">.</span></p>

scholarly journals The challenge of Diagnosing Common Dermatomycosis by Reflectance Confocal Microscopy

2021 ◽  
Vol 6 (3) ◽  
pp. 01-07
Author(s):  
Jianyun Lu ◽  
Jinrong Zeng ◽  
Hanyi Zhang ◽  
Yue Zhang ◽  
Lihua Gao ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Fungal Infections ◽  
Pityriasis Versicolor ◽  
Tinea Corporis ◽  
Reflectance Confocal Microscopy ◽  
Fungal Culture ◽  
Image Characteristics ◽  
Tinea Manus ◽  
Microscopy Techniques

Background: Traditional detection of fungal infections of the skin relies on microscopy techniques or fungal culture. Currently, reflectance confocal microscopy (RCM) has been widely applied to assist the diagnosis of commondermatomycosis with advantages of non-invasiveness, celerity, real time, and repeatability. Materials and Methods: A total of 478 clinically suspected dermatomycosis patients were enrolled in this study including 148 cases of tinea manus and pedis, 188 cases of tinea corporis and cruris and 142 cases of pityriasis versicolor. RCM examination was performed to image the lesions. Aim: This study aimed to summarize the image characteristics of in vivo RCM examination on common dermatomycosis and retrospectively evaluate its accuracy as compared with microscopy results. Furthermore, we attempted to tackle the challenges of RCM diagnosis on common dermatomycosis. Results: Based on RCM images, 231 of 478 (48.3%) patients were detected with hyphae. Among all RCM confirmed cases, 58 out of 148 (39.2%) were tinea manus and pedis, 145 out of 188 (77.1%) were tinea corporis and cruris, and 28 out of 142 (19.7%) were pityriasis versicolor. The remaining patients (51.7%) could not be diagnosed by the dermatologist according to RCM. Hyphae structures were primarily identified during diagnoses of dermatomycosis by RCM. Conclusions: RCM is a novel optical imaging technique that confers high-resolution images of fungi. RCM has certain advantages in the diagnosis of tinea manus and pedis. RCM is not suitable for the diagnosis of pityriasis versicolor.

scholarly journals 267. Fungal Culture Diagnostic Stewardship: An Avenue for Antimicrobial Stewardship in the Immunocompromised Host

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S148-S148
Author(s):  
Pooja Gurram ◽  
Kirtivardhan Vashistha ◽  
John C O’Horo ◽  
Aditya Shah
Keyword(s):  
Antimicrobial Stewardship ◽  
Candida Species ◽  
Fungal Infections ◽  
Immunocompromised Host ◽  
Common Species ◽  
Aspergillus Species ◽  
Fungal Culture ◽  
Penicillium Species ◽  
Fungal Organisms ◽  
Disseminated Disease

Abstract Background Bronchoalveolar lavage (BAL) is a widely used procedure in the diagnosis of pneumonia in critically ill and immunocompromised hosts. Fungal smears and cultures are commonly performed on these samples. We evaluated the yield of various fungi, including but not limited to Candida species, Aspergillus species, Penicillium species, isolated from BAL specimens at our institution to determine the yield of this test and its impact on decision making. Methods We identified adult immunocompromised patients who underwent “Bronchoscopy with Immunocompromised Host Protocol (ICH),” which consists of an exhaustive list of diagnostic tests for various pathogenic organisms, over a one year period from January 1, 2017 to December 31, 2017. We reviewed if positive fungal cultures led to a change in management and if this was appropriate. Results 582 patients underwent bronchoscopy with ICH protocol. There were 285/582 (48.9%) positive fungal cultures of which 177 (62%) grew Candida species. The most common species was Candida albicans (142/177, 80%). 53(18%) were Aspergillus species of which Aspergillus fumigatus was the most common (26/53). 16/285 (5.6%) patients underwent intervention based on the results, 14(87.5%) of which were appropriate. 176/177 (99.4%) patients with Candida species in BAL cultures were not treated.10/53 (18. 8%) patients with Aspergillus species in BAL cultures were treated of which 80% were appropriate interventions based on proven/probable invasive fungal infections criteria as were rest of the 6/16 patients with other fungal organisms (Table 4). Patients with Aspergillus species in BAL cultures are 8 times more likely to have an intervention (OR: 8. 7, P = < 0. 0001) while patients with Candida species in BAL cultures are not likely to be intervened upon (OR: 0. 26, P = 0. 0098) (Table 3). Conclusion Although Candida species is commonly isolated in BAL cultures its clinical significance is minimal in the absence of disseminated disease even in immunosuppressed hosts. Evaluating the way that Candida cultures are communicated for respiratory specimens, along with diagnostic stewardship may be a route for antimicrobial stewardship. Consulting ID service early on is essential in assessing the significance of fungal culture data thereby resulting in appropriate changes in management. Disclosures All authors: No reported disclosures.

SARS CoV-2 VIRUS Vs OPPORTUNISTIC MYCOSES

2021 ◽  
pp. 70-72
Author(s):  
Indira Ananthapadmanab asamy ◽  
G. Rajaram ◽  
CH. Srinivasa Rao
Keyword(s):  
Fungal Infections ◽  
Rna Virus ◽  
Severe Pneumonia ◽  
Predisposing Factors ◽  
Fungal Culture ◽  
Direct Microscopy ◽  
Nasal Tissue ◽  
Positive Sense ◽  
Opportunistic Mycoses ◽  
Novel Coronavirus

Purpose: SARS CoV 2 virus a novel coronavirus, which is a single stranded positive sense RNA virus. It causes severe pneumonia in susceptible individuals. In individuals with predisposing factors, like diabetes, neutropenia, corticosteroids therapy, and etc., the virus causes opportunistic fungal infections. This study aims the correlation between COVID 19 disease and fungal infections. Methodology: The present study includes 202 specimens collected from patients with symptoms suspected of fungal infections. The collected specimens were subjected to direct microscopy and fungal culture. Results: Nasal tissue scrapings were the most common specimen collected followed by sputum. Among the 202 specimens collected, 106 were positive for direct microscopy and 81 were positive for fungal culture. Conclusion: The fungal infections are more common among the patients with comorbidities, and appropriate guidelines should be followed in the management of such infections in order to prevent the morbidity and the mortality.

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