Fungal, Bacterial, and Viral Infections of the Skin

2018 ◽  
Author(s):  
Jan V. Hirschmann

The skin can become infected by viruses, fungi, and bacteria, including some that ordinarily are harmless colonizing organisms. The most common fungal infections are caused by dermatophytes, which can involve the hair, nails, and skin. Potassium hydroxide (KOH) preparations of specimens from affected areas typically demonstrate hyphae, and either topical or systemic antifungal therapy usually cures or controls the process. The most common bacterial pathogens are Staphylococcus aureus and group A streptococci, which, alone or together, can cause a wide variety of disorders, including impetigo, ecthyma, and cellulitis. Topical antibiotics may suffice for impetigo, but ecthyma and cellulitis require systemic treatment. S. aureus, including methicillin-resistant strains, can also cause furuncles, carbuncles, and cutaneous abscesses. For these infections, incision and drainage without antibiotics are usually curative. Warts are the most common cutaneous viral infection, and eradication can be difficult, especially where the skin is thick, such as the palms and soles, or the patient is immunocompromised. Most therapies consist of trying to destroy the viruses by mechanical, chemical, or immune mechanisms. This review covers dermatophyte infections, yeast infections, bacterial infections, and viral infections of the skin. Figures show the classic annular lesion of tinea corporis, a typical kerion presenting as a zoophilic Microsporum canis infection of the scalp (tinea capitis), tinea corporis, tinea barbae, tinea pedis between and under the toes and on the plantar surface, inflammatory tinea pedis, tinea unguium, tinea manuum, angular cheilitis, prominent satellite lesions of discrete vesicles associated with candidiasis, facial candidiasis, Candida paronychia, tinea versicolor, nonbullous impetigo, bullous impetigo, ecthyma, leg cellulitis, erythema and edema on the cheeks, eyelids, and nose, furuncle, carbuncle, nasal folliculitis, pitted keratolysis, trichomycosis axillaris, necrotizing fasciitis, Fournier gangrene, folliculitis, plantar wart, condyloma acuminatum, and benign lesions of bowenoid papulosis. Tables list dermatophyte species, terminology of dermatophyte infections, topical agents for dermatophyte infections, treatment options for impetigo (adult doses), and treatment options for erythrasma.   This review contains 29 figures, 5 tables, and 33 references. Keywords: Staphylococcus aureus, methicillin-resistant strains, furuncles, carbuncles, cutaneous abscesses, dermatophytes, zoophilic Microsporum canis, andidiasis, facial candidiasis, Candida paronychia, tinea versicolor, nonbullous impetigo, bullous impetigo, ecthyma, leg cellulitis, erythema

2016 ◽  
Author(s):  
Jan V. Hirschmann

The skin can become infected by viruses, fungi, and bacteria, including some that ordinarily are harmless colonizing organisms. The most common fungal infections are caused by dermatophytes, which can involve the hair, nails, and skin. Potassium hydroxide (KOH) preparations of specimens from affected areas typically demonstrate hyphae, and either topical or systemic antifungal therapy usually cures or controls the process. The most common bacterial pathogens are Staphylococcus aureus and group A streptococci, which, alone or together, can cause a wide variety of disorders, including impetigo, ecthyma, and cellulitis. Topical antibiotics may suffice for impetigo, but ecthyma and cellulitis require systemic treatment. S. aureus, including methicillin-resistant strains, can also cause furuncles, carbuncles, and cutaneous abscesses. For these infections, incision and drainage without antibiotics are usually curative. Warts are the most common cutaneous viral infection, and eradication can be difficult, especially where the skin is thick, such as the palms and soles, or the patient is immunocompromised. Most therapies consist of trying to destroy the viruses by mechanical, chemical, or immune mechanisms. This review covers dermatophyte infections, yeast infections, bacterial infections, and viral infections of the skin. Figures show the classic annular lesion of tinea corporis, a typical kerion presenting as a zoophilic Microsporum canis infection of the scalp (tinea capitis), tinea corporis, tinea barbae, tinea pedis between and under the toes and on the plantar surface, inflammatory tinea pedis, tinea unguium, tinea manuum, angular cheilitis, prominent satellite lesions of discrete vesicles associated with candidiasis, facial candidiasis, Candida paronychia, tinea versicolor, nonbullous impetigo, bullous impetigo, ecthyma, leg cellulitis, erythema and edema on the cheeks, eyelids, and nose, furuncle, carbuncle, nasal folliculitis, pitted keratolysis, trichomycosis axillaris, necrotizing fasciitis, Fournier gangrene, folliculitis, plantar wart, condyloma acuminatum, and benign lesions of bowenoid papulosis. Tables list dermatophyte species, terminology of dermatophyte infections, topical agents for dermatophyte infections, treatment options for impetigo (adult doses), and treatment options for erythrasma.   This review contains 29 figures, 5 tables, and 33 references. Keywords: Staphylococcus aureus, methicillin-resistant strains, furuncles, carbuncles, cutaneous abscesses, dermatophytes, zoophilic Microsporum canis, andidiasis, facial candidiasis, Candida paronychia, tinea versicolor, nonbullous impetigo, bullous impetigo, ecthyma, leg cellulitis, erythema


2018 ◽  
Author(s):  
Jan V. Hirschmann

The skin can become infected by viruses, fungi, and bacteria, including some that ordinarily are harmless colonizing organisms. The most common fungal infections are caused by dermatophytes, which can involve the hair, nails, and skin. Potassium hydroxide (KOH) preparations of specimens from affected areas typically demonstrate hyphae, and either topical or systemic antifungal therapy usually cures or controls the process. The most common bacterial pathogens are Staphylococcus aureus and group A streptococci, which, alone or together, can cause a wide variety of disorders, including impetigo, ecthyma, and cellulitis. Topical antibiotics may suffice for impetigo, but ecthyma and cellulitis require systemic treatment. S. aureus, including methicillin-resistant strains, can also cause furuncles, carbuncles, and cutaneous abscesses. For these infections, incision and drainage without antibiotics are usually curative. Warts are the most common cutaneous viral infection, and eradication can be difficult, especially where the skin is thick, such as the palms and soles, or the patient is immunocompromised. Most therapies consist of trying to destroy the viruses by mechanical, chemical, or immune mechanisms. This review covers dermatophyte infections, yeast infections, bacterial infections, and viral infections of the skin. Figures show the classic annular lesion of tinea corporis, a typical kerion presenting as a zoophilic Microsporum canis infection of the scalp (tinea capitis), tinea corporis, tinea barbae, tinea pedis between and under the toes and on the plantar surface, inflammatory tinea pedis, tinea unguium, tinea manuum, angular cheilitis, prominent satellite lesions of discrete vesicles associated with candidiasis, facial candidiasis, Candida paronychia, tinea versicolor, nonbullous impetigo, bullous impetigo, ecthyma, leg cellulitis, erythema and edema on the cheeks, eyelids, and nose, furuncle, carbuncle, nasal folliculitis, pitted keratolysis, trichomycosis axillaris, necrotizing fasciitis, Fournier gangrene, folliculitis, plantar wart, condyloma acuminatum, and benign lesions of bowenoid papulosis. Tables list dermatophyte species, terminology of dermatophyte infections, topical agents for dermatophyte infections, treatment options for impetigo (adult doses), and treatment options for erythrasma.   This review contains 28 highly rendered figures, 5 tables, and 33 references


2021 ◽  
pp. 29-39
Author(s):  
А.К. САДАНОВ ◽  
В.Э. БЕРЕЗИН ◽  
И.Р. КУЛМАГАМБЕТОВ ◽  
Л.П. ТРЕНОЖНИКОВА ◽  
А.С. БАЛГИМБАЕВА

Розеофунгин-АС, мазь 2% для наружного применения разработана для лечения микозов кожи разной этиологии, вызванных дерматофитными, дрожжеподобными и плесневыми грибами. Многоцентровое слепое проспективное рандомизированное исследование проводили в Республике Казахстан для сравнения терапевтической эффективности и безопасности препаратов «Розеофунгин-АС, мазь 2%» и «Клотримазол, крем 1%» при лечении tinea pedis и tinea corporis. Препараты применяли 2 раза в день в течение 28 дней. Лабораторные общеклинические и биохимические обследования пациентов проводили на 0, 14 и 28 дни исследования. Микологическое обследование включало микроскопические и культуральные исследования, которые проводились до лечения и на 28-30-й день после окончания лечения. В клиническое исследование III фазы входили 410 пациентов, включая 290 пациентов с tinea pedis и 120 пациентов с tinea corporis. Лечение препаратом «Розеофунгин-АС, мазь 2%» получали 310 пациентов, лечение препаратом «Клотримазол, крем 1%» - 100 пациентов. У больных обеих групп уже на 14 день уменьшалась выраженность субъективных и объективных проявлений. К 28 дню практически все клинические признаки патологического процесса отсутствовали. Совокупная клинико-микологическая эффективность препарата «Розеофунгин-АС, мазь 2%» составила 99,1%, препарата «Клотримазол, крем 1%» - 98,0%. Препарат «Розеофунгин-АС, мазь 2%» проявил высокую эффективность при лечении грибковых инфекций tinea pedis и tinea corporis, вызванных возбудителями трихофитии (Trihophyton rubrum, T. violarum, T. tonsurans), микроспории (Microsporum canis, M. gypseum), кандидоза (Candida albicans, Candida spp.), плесневыми грибами (Penicillium glaucum). В исследовании не были зафиксированы аллергические реакции и индивидуальная непереносимость исследуемого и референтного препаратов. Препарат «Розеофунгин-АС, мазь 2%» является эффективным антимикотическим средством, клинико-микологическая эффективность которого в терапии микозов кожи составляет 99,1%. Препарат имеет высокий уровень переносимости, безопасности и приемлемости RoseofunginAS, ointment 2% for external use was developed for the treatment of skin mycoses of various etiologies caused by dermatophytic and yeastlike fungi and molds. A multicenter, blind, prospective, randomized trial was conducted in the Republic of Kazakhstan to compare the therapeutic effectiveness and safety of RoseofunginAS, ointment 2% and Clotrimazole, cream 1% in the treatment of tinea pedis and tinea corporis. The drugs were administered twice daily for 28 days. Laboratory general clinical and biochemical examinations of patients were performed on days 0, 14, and 28 of the trial. Mycological examination included microscopic and cultural studies, which were carried out before treatment and on days 2830 after the end of treatment. The Phase III clinical trial involved 410 patients, including 290 with tinea pedis and 120 with tinea corporis. Treatment with RoseofunginAS, ointment 2% was administered to 310 patients, 100 patients were treated with Clotrimazole, cream 1%. In patients of both groups, the severity of subjective and objective manifestations decreased already on day 14. By day 28, almost all clinical signs of the pathological process were absent. The cumulative clinical and mycological effectiveness of the drug RoseofunginAS, ointment 2% was 99.1% and that of the drug Clotrimazole, cream 1% reached 98.0%. The drug RoseofunginAS, ointment 2% exhibited high effectiveness in the treatment of fungal infections, including tinea pedis and tinea corporis, with pathogens that cause trichophytosis (Trihophyton rubrum, T. violarum, T. tonsurans), microsporia (Microsporum canis, M. gypseum), candidiasis (Candida albicans, Candida spp.), and molds (Penicillium glaucum). The study did not record allergic reactions and individual intolerance to the study and reference drug. The drug RoseofunginAS, ointment 2% is an effective antimycotic agent, the clinical and mycological effectiveness of which in the treatment of skin mycoses was 99.1%. The drug possesses a high level of tolerance, safety and acceptability.


Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 543
Author(s):  
Ozioma F. Nwabor ◽  
Sukanlaya Leejae ◽  
Supayang P. Voravuthikunchai

As the burden of antibacterial resistance worsens and treatment options become narrower, rhodomyrtone—a novel natural antibiotic agent with a new antibacterial mechanism—could replace existing antibiotics for the treatment of infections caused by multi-drug resistant Gram-positive bacteria. In this study, rhodomyrtone was detected within the cell by means of an easy an inexpensive method. The antibacterial effects of rhodomyrtone were investigated on epidemic methicillin-resistant Staphylococcus aureus. Thin-layer chromatography demonstrated the entrapment and accumulation of rhodomyrtone within the bacterial cell wall and cell membrane. The incorporation of radiolabelled precursors revealed that rhodomyrtone inhibited the synthesis of macromolecules including DNA, RNA, proteins, the cell wall, and lipids. Following the treatment with rhodomyrtone at MIC (0.5–1 µg/mL), the synthesis of all macromolecules was significantly inhibited (p ≤ 0.05) after 4 h. Inhibition of macromolecule synthesis was demonstrated after 30 min at a higher concentration of rhodomyrtone (4× MIC), comparable to standard inhibitor compounds. In contrast, rhodomyrtone did not affect lipase activity in staphylococci—both epidemic methicillin-resistant S. aureus and S. aureus ATCC 29213. Interfering with the synthesis of multiple macromolecules is thought to be one of the antibacterial mechanisms of rhodomyrtone.


1985 ◽  
Vol 27 (5) ◽  
pp. 685-687 ◽  
Author(s):  
P M Sullam ◽  
M G Tauber ◽  
C J Hackbarth ◽  
H F Chambers ◽  
K G Scott ◽  
...  

2015 ◽  
Vol 59 (4) ◽  
pp. 2458-2461 ◽  
Author(s):  
Helio S. Sader ◽  
Robert K. Flamm ◽  
Jennifer M. Streit ◽  
David J. Farrell ◽  
Ronald N. Jones

ABSTRACTA total of 84,704 isolates were collected from 191 medical centers in 2009 to 2013 and tested for susceptibility to ceftaroline and comparator agents by broth microdilution methods. Ceftaroline inhibited allStaphylococcus aureusisolates at ≤2 μg/ml and was very active against methicillin-resistant strains (MIC at which 90% of the isolates tested are inhibited [MIC90], 1 μg/ml; 97.6% susceptible). AmongStreptococcus pneumoniaeisolates, the highest ceftaroline MIC was 0.5 μg/ml, and ceftaroline activity against the most commonEnterobacteriaceaespecies (MIC50, 0.12 μg/ml; 78.9% susceptible) was similar to that of ceftriaxone (MIC50, ≤0.25 μg/ml; 86.8% susceptible).


2020 ◽  
Vol 27 (07) ◽  
pp. 1363-1370
Author(s):  
Aneela Khawaja ◽  
Iffat Javed ◽  
Sohaila Mushtaq ◽  
Saeed Anwar ◽  
Faiqa Arshad ◽  
...  

Antimicrobial resistance (AMR) is a devastating question that is threatening the health globally. The extensive and indiscriminative use of antibiotics has evolved a notorious resistance in Staphylococcus aureus.  This resistance developed through possession of mecA gene, which codes for modified penicillin binding protein (PBP2a) and the emergent strain being labeled “methicillin resistant Staphylococcus aureus”. Conventional phenotypic techniques for detection of MRSA rely on standardization of cultural characteristics. The drawbacks of diagnostic error to report MRSA include: poor prognosis, expensive treatment, dissemination of multi-drug resistant strains and even treatment failure. Latex agglutination method can be adopted as a more accurate and quick strategy for rapid detection of methicillin resistance. Objectives: To compare detection of mecA gene in methicillin resistant isolates of Staphylococcus aureus by latex agglutination and PCR; by assessing the sensitivity and specificity of both methods. Study Design: Descriptive Cross-Sectional study. Setting: Pathology Department, Post Graduate Medical Institute, Lahore. Period: From January 2015 to December 2015; according to standard operating procedures at Microbiology laboratory. Material & Methods: A total 713 consecutive, non-duplicate isolates of Staphylococcus aureus were processed. Methicillin resistance was determined using cefoxitin (30mg) by Kirby-Bauer method using CLSI guideline (2016), latex agglutination method; and PCR for mecA gene. Results: The results showed that out of 713 Staphylococcus aureus isolates, 92 (12.90%) isolates were resistant to cefoxitin and were labelled as MRSA. majority MRSA isolates recovered from pus (44.57%) and wound swab (20.65%), followed by blood (13.04%), fluid (8.70%), CSF (4.35%), CVP (3.26%), HVS (3.26%) and tracheal secretion (2.17%). By latex agglutination method, 87 (94.50%) were positive for PBP2a; while on PCR mecA gene was detected only in 82 (89.10%) MRSA isolates. When assessed with PCR (gold standard) the sensitivity and diagnostic accuracy of latex agglutination was 100% and 94.57%, respectively. Conclusion: Latex agglutination test can be employed as rapid and reliable diagnostic technique in MRSA isolates for mecA gene detection, where resources for molecular methods are inadequate. This can effectually lessen the misdiagnosis of resistant strains, and over/ ill-use of antibiotics.


1992 ◽  
Vol 30 (8) ◽  
pp. 2092-2096 ◽  
Author(s):  
M J Carles-Nurit ◽  
B Christophle ◽  
S Broche ◽  
A Gouby ◽  
N Bouziges ◽  
...  

2015 ◽  
Vol 26 (3) ◽  
pp. 233-243
Author(s):  
Kristine Anne Scordo

Methicillin-resistant Staphylococcus aureus (MRSA) continues to cause significant morbidity and mortality. Despite advances in medical care, the prevalence of both community-acquired and hospital-acquired MRSA has progressively increased. Community-acquired MRSA typically occurs in patients without recent illness or hospitalization, presents as acute skin and soft tissue infections, and is usually not multidrug resistant. Hospital-acquired MRSA, however, presents in patients recently hospitalized or treated in long-term care settings and in those who have had medical procedures and is usually associated with multidrug-resistant strains. Both types of infections, if not properly treated, have the potential to become invasive. This article discusses current intravenous antibiotics that are available for the empiric treatment of MRSA infections along with a newer phenomenon known as the “seesaw effect.”


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