Fungal infection

Mycoses are traditionally divided into superficial, subcutaneous, or systemic, where infection is deep, more widespread and involving internal body organs.{{cite book | vauthors = Nakazato G, Alesandra A, Lonni SG, Panagio LA, de Camargo LC, Goncalves MC, Reis GF, Miranda-Sapla MM, Tomiotto-Pellissier F, Kobayashi RK | display-authors = 6 | veditors = Rai M |title=Nanotechnology in Skin, Soft Tissue, and Bone Infections |date=2020 |publisher=Springer |location=Switzerland |isbn=978-3-030-35146-5 |chapter-url=https://books.google.com/books?id=lC3KDwAAQBAJ&pg=PA76 |language=en |chapter=4. Applications of nanometals in cutaneous infections}} They can affect the nails, vagina, skin and mouth.{{cite web |title=Types of Fungal Diseases {{!}} Fungal Diseases {{!}} CDC |url=https://www.cdc.gov/fungal/diseases/index.html |website=www.cdc.gov |access-date=12 June 2021 |language=en-us |date=27 June 2019}} Some types such as blastomycosis, cryptococcus, coccidioidomycosis and histoplasmosis, affect people who live in or visit certain parts of the world. Others such as aspergillosis, pneumocystis pneumonia, candidiasis, mucormycosis and talaromycosis, tend to affect people who are unable to fight infection themselves. Mycoses might not always conform strictly to the three divisions of superficial, subcutaneous and systemic. Some superficial fungal infections can cause systemic infections in people who are immunocompromised. Some subcutaneous fungal infections can invade into deeper structures, resulting in systemic disease. Candida albicans can live in people without producing symptoms, and is able to cause both mild candidiasis in healthy people and severe invasive candidiasis in those who cannot fight infection themselves.

ICD-11 codes include:

{{refbegin|colwidth=15em}}

• 1F20 Aspergillosis
• 1F21 Basidiobolomycosis
• 1F22 Blastomycosis
• 1F23 Candidosis
• 1F24 Chromoblastomycosis
• 1F25 Coccidioidomycosis
• 1F26 Conidiobolomycosis
• 1F27 Cryptococcosis
• 1F28 Dermatophytosis
• 1F29 Eumycetoma
• 1F2A Histoplasmosis
• 1F2B Lobomycosis
• 1F2C Mucormycosis
• 1F2D Non-dermatophyte superficial dermatomycoses
• 1F2E Paracoccidioidomycosis
• 1F2F Phaeohyphomycosis
• 1F2G Pneumocystosis
• 1F2H Scedosporiosis
• 1F2J Sporotrichosis
• 1F2K Talaromycosis
• 1F2L Emmonsiosis

{{refend|colwidth=25em}}

Superficial mycoses include candidiasis in healthy people, common tinea of the skin, such as tinea of the body, groin, hands, feet and beard, and malassezia infections such as pityriasis versicolor.

File:Human tongue infected with oral candidiasis.jpg|Oral candidiasis

File:Dermatophytosis 20190815-02ASD.jpg|Tinea corporis

File:Pityriasis versicolor frontal retouche.jpg|Pityriasis versicolor

File:Toefungus.jpg|Onychomycosis

File:Madura foot..JPG]]

Subcutaneous fungal infections include sporotrichosis, chromoblastomycosis, and eumycetoma.

Systemic fungal infections include histoplasmosis, cryptococcosis, coccidioidomycosis, blastomycosis, mucormycosis, aspergillosis, pneumocystis pneumonia and systemic candidiasis.

Systemic mycoses due to primary pathogens originate normally in the lungs and may spread to other organ systems. Organisms that cause systemic mycoses are inherently virulent.{{explanation needed|date=April 2021}}.{{citation needed|date=July 2020}} Systemic mycoses due to opportunistic pathogens are infections of people with immune deficiencies who would otherwise not be infected. Examples of immunocompromised conditions include AIDS, alteration of normal flora by antibiotics, immunosuppressive therapy, and metastatic cancer. Examples of opportunistic mycoses include Candidiasis, Cryptococcosis and Aspergillosis.{{citation needed|date=July 2020}}

Most common mild mycoses often present with a rash. Infections within the skin or under the skin may present with a lump and skin changes. Less common deeper fungal infections may present with pneumonia-like symptoms or meningitis.

Mycoses are caused by certain fungi; yeasts, molds and some fungi that can exist as both a mold and yeast. They are everywhere and infection occurs after spores are either breathed in, come into contact with skin or enter the body through the skin such as via a cut, wound or injection. Candida albicans is the most common cause of fungal infection in people, particularly as oral or vaginal thrush, often following taking antibiotics.

Fungal infections are more likely in people with weak immune systems.{{cite web |title=Fungal Infections {{!}} Fungal {{!}} CDC |url=https://www.cdc.gov/fungal/infections/index.html |website=www.cdc.gov |access-date=16 June 2021 |language=en-us |date=29 January 2019}} This includes people with illnesses such as HIV/AIDS, and people taking medicines such as steroids or cancer treatments. People with diabetes also tend to develop fungal infections.{{cite web|url=http://www.nhs.uk/Conditions/Thrush-men/Pages/Introduction.aspx|publisher=NHS|title=Thrush in Men|access-date=2013-07-13|archive-date=2013-07-03|archive-url=https://web.archive.org/web/20130703042229/http://www.nhs.uk/conditions/Thrush-men/Pages/Introduction.aspx|url-status=dead}} Very young and very old people, also, are groups at risk.{{cite web |url=http://www.wrongdiagnosis.com/f/fungal_infections/intro.htm |archive-url=https://web.archive.org/web/20030508020121/http://www.wrongdiagnosis.com/f/fungal_infections/intro.htm |url-status=dead |archive-date=May 8, 2003 |title=Fungal infections: Introduction|access-date= May 26, 2010}}

Individuals being treated with antibiotics are at higher risk of fungal infections.{{cite book|title=Acute Care Surgery|date=2012|isbn=9781451153934|page=186|url=https://books.google.com/books?id=PORTzqCiTdIC&pg=PA186| vauthors = Britt LD, Peitzman A, Barie P, Jurkovich G |publisher=Lippincott Williams & Wilkins }}

Children whose immune systems are not functioning properly (such as children with cancer) are at risk of invasive fungal infections.{{cite journal | vauthors = Blyth CC, Hale K, Palasanthiran P, O'Brien T, Bennett MH | title = Antifungal therapy in infants and children with proven, probable or suspected invasive fungal infections | journal = The Cochrane Database of Systematic Reviews | issue = 2 | pages = CD006343 | date = February 2010 | volume = 2015 | pmid = 20166083 | doi = 10.1002/14651858.cd006343.pub2 | pmc = 10576261 }}

During the COVID-19 pandemic some fungal infections have been associated with COVID-19.{{cite web |title=Fungal Diseases and COVID-19 {{!}} CDC |url=https://www.cdc.gov/fungal/covid-fungal.html |website=www.cdc.gov |access-date=7 August 2021 |language=en-us |date=7 June 2021}}{{cite book | veditors = Hoenigl M, Talento AF |title=Fungal Infections Complicating COVID-19 |date=2021 |publisher=MDPI |isbn=978-3-0365-0554-1 |url=https://books.google.com/books?id=6rcsEAAAQBAJ |language=en}}{{cite journal | vauthors = Gangneux JP, Bougnoux ME, Dannaoui E, Cornet M, Zahar JR | title = Invasive fungal diseases during COVID-19: We should be prepared | journal = Journal de Mycologie Médicale | volume = 30 | issue = 2 | pages = 100971 | date = June 2020 | pmid = 32307254 | pmc = 7136887 | doi = 10.1016/j.mycmed.2020.100971 }} Fungal infections can mimic COVID-19 and occur at the same time as COVID-19, and more serious fungal infections can complicate COVID-19. A fungal infection may occur after antibiotics for a bacterial infection which has occurred following COVID-19.{{cite book | vauthors = Saxena SK |title=Coronavirus Disease 2019 (COVID-19): Epidemiology, Pathogenesis, Diagnosis, and Therapeutics |date=2020 |publisher=Springer |location=Singapore |isbn=978-981-15-4813-0 |url=https://books.google.com/books?id=OWzqDwAAQBAJ&pg=PA73 |language=en|page=73}} The most common serious fungal infections in people with COVID-19 include aspergillosis and invasive candidiasis.{{cite web |title=Fungal Diseases and COVID-19 |url=https://www.cdc.gov/fungal/covid-fungal.html |website=www.cdc.gov |access-date=7 August 2021 |language=en-us |date=7 June 2021}} COVID-19–associated mucormycosis is generally less common, but in 2021 was noted to be significantly more prevalent in India.{{cite book | vauthors = Qu JM, Cao B, Chen RC |title=COVID-19: The Essentials of Prevention and Treatment |date=2021 |publisher=Elsevier |location=Amsterdam, Netherlands |isbn=978-0-12-824003-8 |url=https://books.google.com/books?id=OWzqDwAAQBAJ |language=en}}

Fungal infections occur after spores are breathed in, come into contact with skin or enter the body through a wound.

File:Mycology algorithm.png community hospital.]]

Diagnosis is generally by signs and symptoms, microscopy, biopsy, culture and sometimes with the aid of medical imaging.

Some tinea and candidiasis infections of the skin can appear similar to eczema and lichen planus. Pityriasis versicolor can look like seborrheic dermatitis, pityriasis rosea, pityriasis alba and vitiligo.

Some fungal infections such as coccidioidomycosis, histoplasmosis, and blastomycosis can present with fever, cough, and shortness of breath, thereby resembling COVID-19.{{cite web |title=Fungal Diseases and COVID-19 |url=https://www.cdc.gov/fungal/covid-fungal.html |website=www.cdc.gov |access-date=19 June 2021 |language=en-us |date=7 June 2021}}

Keeping the skin clean and dry, as well as maintaining good hygiene, will help larger topical mycoses. Because some fungal infections are contagious, it is important to wash hands after touching other people or animals. Sports clothing should also be washed after use.{{clarify|date=June 2021}}{{citation needed|date=June 2016}}

Treatment depends on the type of fungal infection, and usually requires topical or systemic antifungal medicines.{{cite book| vauthors = Graininger W, Diab-Elschahawi M, Presterl E | veditors = Presterl E |title= Clinically Relevant Mycoses: A Practical Approach |url=https://books.google.com/books?id=-nSADwAAQBAJ|year=2019|publisher=Springer|isbn=978-3-319-92299-7|pages=31–44|chapter=3. Antifungal agents}} Pneumocystosis that does not respond to anti-fungals is treated with co-trimoxazole.{{cite web |title=CDC - DPDx - Pneumocystis |url=https://www.cdc.gov/dpdx/pneumocystis/index.html |website=www.cdc.gov |access-date=25 July 2021 |archive-url=https://web.archive.org/web/20210725110001/https://www.cdc.gov/dpdx/pneumocystis/index.html |archive-date=25 July 2021 |language=en-us |date=22 January 2019}} Sometimes, infected tissue needs to be surgically cut away.

Worldwide, every year fungal infections affect more than one billion people. An estimated 1.6 million deaths from fungal disease were reported in 2017.{{cite journal | vauthors = | title = Stop neglecting fungi | journal = Nature Microbiology | volume = 2 | issue = 8 | pages = 17120 | date = July 2017 | pmid = 28741610 | doi = 10.1038/nmicrobiol.2017.120 | doi-access = free }} The figure has been rising, with an estimated 1.7 million deaths from fungal disease reported in 2020. Fungal infections also constitute a significant cause of illness and mortality in children.{{cite journal | vauthors = Sehgal M, Ladd HJ, Totapally B | title = Trends in Epidemiology and Microbiology of Severe Sepsis and Septic Shock in Children | journal = Hospital Pediatrics | volume = 10 | issue = 12 | pages = 1021–1030 | date = December 2020 | pmid = 33208389 | doi = 10.1542/hpeds.2020-0174 | s2cid = 227067133 | doi-access = free }}

According to the Global Action Fund for Fungal Infections, every year there are over 10 million cases of fungal asthma, around 3 million cases of long-term aspergillosis of lungs, 1 million cases of blindness due to fungal keratitis, more than 200,000 cases of meningitis due to cryptococcus, 700,000 cases of invasive candidiasis, 500,000 cases of pneumocystosis of lungs, 250,000 cases of invasive aspergillosis, and 100,000 cases of histoplasmosis.{{cite journal | vauthors = Rodrigues ML, Nosanchuk JD | title = Fungal diseases as neglected pathogens: A wake-up call to public health officials | journal = PLOS Neglected Tropical Diseases | volume = 14 | issue = 2 | pages = e0007964 | date = February 2020 | pmid = 32078635 | pmc = 7032689 | doi = 10.1371/journal.pntd.0007964 | doi-access = free }}

In 500 BC, an account of ulcers in the mouth by Hippocrates may have described thrush.{{cite book | vauthors = Homei A, Worboys M |title=Fungal Disease in Britain and the United States 1850-2000: Mycoses and Modernity |date=11 November 2013 |publisher=Springer |isbn=978-0-333-71492-8 |page=6 |url=https://books.google.com/books?id=wVDyAQAAQBAJ |language=en |chapter=1. Introduction}} Paris-based Hungarian microscopist David Gruby first reported that human disease could be caused by fungi in the early 1840s.

During the 2003 SARS outbreak, fungal infections were reported in 14.8–33% of people affected by SARS, and it was the cause of death in 25–73.7% of people with SARS.{{cite journal | vauthors = Song G, Liang G, Liu W | title = Fungal Co-infections Associated with Global COVID-19 Pandemic: A Clinical and Diagnostic Perspective from China | journal = Mycopathologia | volume = 185 | issue = 4 | pages = 599–606 | date = August 2020 | pmid = 32737747 | pmc = 7394275 | doi = 10.1007/s11046-020-00462-9 }}

A wide range of fungal infections occur in other animals, and some can be transmitted from animals to people, such as Microsporum canis from cats.

• {{section link|Plant diseases|Fungi}}
• Actinomycosis
• Climate change and infectious diseases

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{{Medical resources

| ICD10 = {{ICD10|B|35||b|35}}-{{ICD10|B|49||b|35}}

| ICD9 = {{ICD9|110}}-{{ICD9|118.99}}

| ICDO =

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| DiseasesDB = 28821

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| MeshID = D009181

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{{Infectious_disease}}

{{Mycoses}}

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Category:Tropical diseases

Category:Animal fungal diseases

Category:Fungal diseases