What are fungal infections of the nails

What are fungal infections of the nails?

Fungal infections of the nails are common. The fungus grows in the nail bed, where the nail meets the skin. The fungus grows slowly and does not spread to internal organs. The main concern is the nail discoloration (usually yellow) and change in nail texture and growth. Nails can become crumbly, break easily, and grow irregularly. But because other nail conditions can mimic fungal infection, most doctors will confirm the diagnosis by sending a nail clipping for laboratory evaluation – especially if treatment is being considered.

Fungal infections are not commonly contagious or spread easily between people. The fungus grows in people whose bodies “allow” the fungus to become established without mounting an immune response to suppress the fungus. We know of no ways to boost your immune system to make fungal infections less likely. You may be able to prevent fungus infections by:

Keeping your feet dry, avoiding constant moisture

Avoid non porous, closed shoes made of synthetic materials

Wearing absorbent socks

Wearing water proof sandals when in public showers

What can be done about fungal nail infection?

Because the fungus grows slowly, it is hard to eliminate. The anti fungal medications that eliminate the fungus are strong, must be taken by mouth, and must be taken conscientiously for months in order to be effective. Each drug has potential side effects on other body organs (especially the liver, skin, or bone marrow). To monitor for side effects, periodic blood testing must be obtained, usually monthly, during the time you take the medication. Any symptoms suggesting organ damage should be reported immediately to your physician, such as: unusual fatigue, severe loss of appetite, nausea, yellow eyes, dark urine, pale stool, skin rashes, bleeding, enlarged lymph glands, or signs of infection.

Unfortunately, anti fungal creams applied directly to the nail cannot penetrate the nail bed to kill the fungus at its source, so they are not usually effective.

How effective are the medications at curing the fungus?

The anti fungal medications usually suppress the nail infection when taken as directed. Unfortunately, they cannot guarantee permanent cure. At least 1 in 5 patients (20%) and probably more will have a recurrence of the original nail infection at some time, and re-treatment with medication would be necessary.

Should I take medication to treat my fungal nail infection?

Doctors usually recommend treating fungal nail infections only when such infections cause secondary problems, like pain, recurring ingrown toenails, or secondary bacterial infections of the nails or skin. If the nail infection causes no symptoms, then doctors often will discourage treatment because of the potential side effects, the need to monitor the blood throughout therapy, and the high recurrence rate. Patients with liver or heart disease generally should not take these medications.

Some insurance companies require documentation of secondary problems beyond the mere presence of the fungal infection before they will cover the costs of the anti fungal medications.

April 2002

Acknowledgment and Thanks

Palo Alto Medical Foundation

Four Key Features of a Fungus

Four Key Features of a Fungus

1.) Fungi are a kingdom consisting entirely of absorptive heterotrophs. In contrast to certain bacteria and autotrophic plants, they need pre-formed organic compounds as energy sources, and as carbon sources for cellular synthesis. Fungi characteristically live embedded in some form of food substrate where they absorb simple, soluble nutrients through the wall and cell membrane. In many cases, these simple nutrients may be released from more complex polymers by depolymerases that are secreted into the external medium. It is therefore unlikely that there is a substrate anywhere in the world that a fungus cannot utilize or benefit from. It should be noted the cell wall of the fungi prevents food being engulfed by phagocytosis.

2.) Fungi usually are filamentous, with the single filaments being termed hyphae. Fungal hyphae grow and branch to produce a network of filaments which constitutes the mycelium. The mycelium enlarges by extension of single hyphae which show polar growth, meaning they grow only at their extreme tips. This apical growth is in contrast to the intercalary growth of most other filamentous organisms. Expansion of the mycelium is continuous if the hyphae can keep on extending on the medium they are residing in. However, changes do take place as the mycelium ages and as that part of the food source on which it is growing is no longer able to provide sufficient nutrients. It should be noted here that though many fungi are hyphae in character, with an indeterminate mycelium capable of producing the largest of organisms, there are actually five major body forms in the kingdom.

3.) Fungi can reproduce by both asexual and sexual means. Reproduction is invariably connected to the production of spores, produced at specialized structures and fully equipped to start a new colony independent of the parent mycelium, and usually some distance from it. Fungal spores vary enormously in shape, size and other special properties, linked to their numerous roles in dispersal or survival.

4.) Fungi are all eukaryotic. This means they have a membrane-bound nucleus containing several chromosomes (unlike a circular strand of DNA found in prokaryotes), and a number of membrane-bound organelles including mitochondria and vacuoles. Eukaryotes also contain DNA that includes non-coding regions entitled introns, and ribosomes of the 80S type, contrary to the 70S type found in prokaryotes.

In summary, fungi are a kingdom of heterotrophic absorptive eukaryotes which probably arose from a choanoflagellate like protozoan by the origin of beta-glucan/chitin walls, with the simultaneous loss of phagotrophy. Multiple losses and origins of complex characters would have occurred since then, including major changes in wall chemistry, sometimes totally losing the whole vegetative wall. Fungi are ordinarily aerobic, having mitochondria with flat cristae and peroxisomes, the latter giving yeasts some of their chemical virtuosity. The 'true' fungi consist of the phyla Chytridiomycota, Zygomycota, Ascomycota and Basidiomycota, each sharing important morphological and biochemical features, such as walls typically containing chitin. Fungi are restricted to a monophyletic lineage, the closest relatives to these true fungi being the Choanoflagellates, a group ancestral to multicellular animals too. The true fungi display evident evolutionary trends with respect to their colony structure, ecological relationships, cell form, life cycle and sexuality.(1)

(1) World of Fungus

Lymphedema and Preventing Fungal Infections

Lymphedema and Preventing Fungal Infections

Not every infection we get as lymphedema patient is due to a bacterial "invasion."

We can also very quickly come down with a fungal infection.  Due to the immunocompromised condition of the lymphedema limb, this fungus may literally explode over the limb before we even know what hit us.

It is critical that we know:

How to Prevent Fungal Infections

Getting rid of a fungal infection is not all that difficult. Your doctor may decide to scrape a small amount of the irritated skin or clip off a piece of hair or nail and look at it under a microscope. Once your doctor knows what kind of infection you have, there are special antifungal creams and shampoos that can help to get rid of it. Sometimes the doctor will prescribe a medicine to take by mouth for many weeks. Make sure you take the medicine for as long as the doctor tells you.

Maybe fungal infections can't be avoided altogether, but there are some ways you can help yourself ward them off.

Walk away from athlete's foot by following these simple steps:

Wash your feet everyday.

Dry your feet completely, especially between your toes.

Wear sandals or shower shoes when walking around in locker rooms, public pools, and public showers.

Wear clean socks and if they get wet or damp, be sure to change them as soon as you can. Use a powder (talcum or antifungal) on your feet to help reduce perspiration.

You may love to play sports and not be able to avoid jock itch, but you can help to keep it away when you:

Wear clean, cotton underwear and loose-fitting pants.

Keep your groin area clean and dry.

Yeast infections can be avoided, too, if you:

Don't hang out in wet swimsuits; change as soon as possible. Wear clean, cotton underpants.

The truth is there may always be a “fungus among us,” but we can make it a lot tougher for them to invade and grow!

Reviewed by: Patrice Hyde, MD Date reviewed: November 2000

Acknowledgment and Thanks Kids Health What are the different types of fungal infection?

When it comes to human body, the term fungus refers to a type of germ that lives on all of us. This germ harmless most of the time, can cause problems occasionally. This is called a fungal infection. Persistent fungal infections may be indicators of an imbalance in the body's microflora (the small, usually bacterial, inhabitants of gut,skin surfaces and mucous membranes).

Also, from AOCD Dermatologic Disease Database

1. Use the medicine completely and as recommended. The fungus may till be present long after it is no longer visible as a rash.

2. Keep feet clean, cool and dry. Change socks. Wear shoes that “breathe” like leather, rather than plastic.

3. Make sure shoes fit correctly and are not too tight.

4. Apply an anti-fungal cream, like Lotrimin or Lamisil, or a prescription antifungal cream to the bottom of the feet, and on the nails, about twice a week. This may help prevent early re-growth of the fungus. In some cases, an oral medication may be prescribed.

5. Avoid walking barefoot, especially in bathrooms, locker rooms, gyms, on carpeting, and in public bathing areas. Wear slippers or stand on a towel or piece of paper.

6. Keep toenails short, cut straight across and avoid ingrown nails. Do not use the same clippers on abnormal nails and normal nails.

7. Family members and close personal contacts should treat any fungus infections they may have to avoid trading back and forth.

8. Apply an anti-fungal powder, like Zeasorb-AF to the shoes every day, to keep spores from growing.

9. Discard old shoes, boots, slippers and sneakers. Do not share footwear with others.

10.If one has had a body fungus, in the groin or elsewhere on the skin, consider using an anti-dandruff shampoo, like Selsun Blue on this area twice a month. Lather up and leave it on the skin for about five minutes, then wash off completely. In some cases a preventive medication may be prescribed.