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Fungal Infections

Fungal infections


Fungi are types of parasitic plants that include molds, mildew, and yeast. A fungal infection is an inflammatory condition in which fungi multiply and invade the skin, the digestive tract, the genitals, and other body tissues, particularly, the lungs and liver. Fungal infections of the skin are often called ringworm or tinea.


Microscopic fungi, which are called dermatophytes, often live exclusively on such dead body tissues as hair, the outer layer of the skin, and the nails. The fungus grows best in moist, damp, dark places with poor ventilation and on skin that is irritated, weakened, or continuously moist. Superficial fungal infections include tinea capitis, an infection of the neck and scalp; tinea barbae, also called barber's itch, along the beard area in adult males; tinea corporis on parts of the body, such as the arms, shoulders, or face; tinea cruris, or jock itch , involving the groin; tinea pedis, or athlete's foot ; tinea versicolor; and tinea unguium, or infection of the nails. The term tinea gladiatorum is sometimes used to describe ringworm infections in atheletes. Tinea gladiatorum is most common in swimmers, wrestlers, and athletes involved in other contact sports. Fungal infections of the skin and nails are very common in children, but they can affect all age groups.

Systemic fungal infections occur when spores are touched or inhaled, or there is an overgrowth of fungi in or on the body. Such infections are most often a serious problem in those with suppressed immune systems. Candidiasis is a rather common fungal infection. When it occurs in the mouth, it is called thrush. Less often, it occurs in the mucous membranes of other parts of the digestive system, or in the vagina, heart valves, urinary tract, eyes, or blood. Other systemic fungal infections include aspergillosis, which mostly affects the lungs and may also spread to the brain and kidneys; blastomycosis, a lung infection that may spread through the bloodstream; coccidioidomycosis, also known as San Joaquin or valley fever ; mucormycosis, which can develop into a very serious, life-threatening infection; and histoplasmosis.

Causes & symptoms

Fungi are widespread in the environment, so it is not unusual that a certain amount of fungi and their spores end up being inhaled into the lungs or landing on the skin. Under conditions of moisture, warmth, irritation, or injury, these fungi grow rapidly and may cause illness. Superficial fungal infections may be due to an overgrowth of fungi already present, or the infection may be the result of contact with an infected person or with contaminated surfaces, bed sheets, towels, or clothing. Fungal infections can be spread from one part of the body to another by scratching or touching. Additionally, tinea unguium infections

have been linked to the use of methyl methacrylate, a glue used for attaching acrylic fingernails.

Fungal spores are often present in soil and are likely to be inhaled when the soil is dug up or otherwise disturbed. Systemic fungal infections are commonly contracted in this way. In addition, fungi that normally inhabit the intestines, such as Candida albicans, may multiply, causing an infection due to an overgrowth of the fungi.

Tinea infections usually cause itchy, red, scaly, ring-shaped patches on the skin that spread easily. Hairs in the area of infection often fall out or break off, and the skin may crack. The skin may also develop a secondary bacterial infection. In tinea unguium, the nails discolor, crack, and thicken. Tinea versicolor may cause pigment changes in the skin that persist for up to a year.

Systemic fungal infections develop slowly. Symptoms often may be nonexistent, or there may be only the feeling of having a cold or the flu. Coughing, a fever, chest pain, chills , weight loss, and difficulty with breathing may become evident. Additional symptoms depend on the type and site of the infection.

Fungal infections are more common and more severe in people taking antibiotics, corticosteroids, immunosuppressant drugs, and contraceptives. This is also the case in people with endocrine disorders, immune diseases, and other conditions such as obesity, AIDS, tuberculosis , major burns, leukemia , and diabetes mellitus . Fungal infections often occur due to the use of antibiotic drugs for other conditions, because antibiotics kill off the bacteria that normally keep fungi at bay.


Fungal infections of the skin, hair, and nails often can be diagnosed based on the characteristic appearance of affected areas. A KOH (potassium hydroxide) prep is a simple laboratory test to confirm the diagnosis. The test uses tissue samples treated with a 20% potassium hydroxide solution to detect fungi. Examining the skin with a Wood's ultraviolet lamp is another easy and convenient method to determine the presence of a fungus. Culture and sensitivity testing can be used if a more definitive diagnosis is required. Systemic fungal infections may be initially diagnosed from blood tests. Confirmation is determined by cultures made from sputum, blood, urine, bone marrow, or infected tissue samples.


Among the herbs that slow down or halt the growth of fungus are goldenseal (Hydrastis canadensis ), myrrh (Commiphora molmol ), garlic (Allium sativa ), pau d'arco (Tabeebuia impestiginosa ), turmeric (Curcuma longa ), oregano (Origanum vulgare ), cinnamon (Cinnamonum zeylanicum ), jewelweed, sage (Salvia officinalis ), Impatiens aurea, yellow dock (Rumex crispus ), the lichen known as old man's beard (Usnea barbata ), black walnut husks and bark (Juglans nigra ), licorice (Glycyrrhiza glabra ), and Calendula officinalis. These herbs can be applied to external fungus as infusions, salves, powders, or vinegars. Many of them can also be taken internally as capsules or tinctures. Antifungal herbs can be quite strong, however, and care should be taken that a given remedy is suitable for internal use.

When an infusion is used, the affected area should be washed or soaked in the herbal water for at least 15 minutes twice daily. Store-bought or homemade tea bags can be soaked in water or vinegar for about 10 minutes and then used as a poultice for the same effect. Herbal vinegars make excellent remedies for fungus, as vinegar is in itself antifungal. "Gourmet" vinegars with such antifungal ingredients as oregano and garlic are often readily available at grocery stores. The vinegar can be applied a few times daily with cotton or compresses. In addition, a bentonite clay dusting powder can be useful for drying out the environment of moist skin in which fungus thrives. It works best when mixed with powdered antifungal herbs such as myrrh or goldenseal. Dusting powder is especially helpful for athlete's foot.

Many herbs high in essential oils also have antifungal action, particularly tea tree (Melaleuca alternifolia ), oregano, lavender (Lavandula officinalis ), Eucalyptus spp., rose geranium (Pelargonium graveolens ), peppermint (Mentha piperita ), chamomile (Matricaria recutita ), and myrrh. Peppermint oil is especially helpful in relieving the itching associated with many fungal infections. The simplest way to use aromatherapy to fight fungal infections is to add several drops of any single essential oil or combination of oils to bathwater. Essential oil can also be added to mixtures for soaking or compresses. Tea tree is the herb most frequently recommended for the treatment of superficial fungal infections. As with all essential oils, the full-strength oil should be diluted in a carrier. A dilution of tea tree oil can be made by adding the essential oil to a carrier oil. This mixture can be added directly to the site of a skin infection.

A healthy diet should be maintained. Foods that are high in yeast, such as beer and wine, breads, and baked goods should be avoided. Fermented foods and sugary foods, including honey and fruit juices, should also be avoided until symptoms have cleared. Antifungal culinary herbs such as garlic, tumeric, oregano, sage, and cinnamon should be used liberally in foods. Yogurt containing live cultures can be incorporated into the diet to supply needed gut bacteria, and help reduce digestive infections such as candidiasis and thrush. Lactobacillus acidophilus and Lactobacillus bulgaricus can also be taken directly as supplements.

Supplements that can be taken for fungal infections include vitamins A, B complex, C, and E. Caprylic acid, an extract of the coconut plant, is also recommended as an antifungal, as well as grapefruit seed extract . Essential fatty acids , contained in evening primrose oil , fish liver oil, or flaxseed oil, can help reduce the inflammation of systemic or superficial fungal infections. A dose of one of these oils is recommended as a daily supplement.

Allopathic treatment

Superficial fungal infections are usually treated with such antifungal creams or sprays as tolnaftate (Aftate or Tinactin), clotrimazole, miconazole nitrate (Micatin products), econazole, ketoconazole, ciclopirox, naftifine, itraconazole, terbinafine, fluconazole, or Whitfield's tincture made of salicylic acid and benzoic acid. If the infection is resistant, a doctor may prescribe an oral antifungal drug such as ketoconazole or griseofulvin. Drugs used for systemic infections include amphotericin B, which is highly toxic and is used for severe or life-threatening infections; the azoles, particularly fluconazole and itraconazole, which have been found to be the least toxic of these medications; and flucytosine alone or in combination with other antifungal medications. Fungal infections that become inflamed may be treated with a combination antifungal/steroid medication. Certain infections may require surgery.

Expected results

Infections usually respond to treatment within several weeks. However, many fungal infections are resistant to treatment, and it may take an extended time and repeated treatments to effect a cure. Infections may spread, and secondary bacterial infections may develop. Medications for fungal infections are often strong, and their use may cause such undesirable side effects as headache, dizziness, nausea, vomiting , or abdominal pain. Fungal infections are usually not serious in otherwise healthy individuals. However, a systemic fungal infection may be severe and life-threatening for those with compromised immune systems.


Good personal hygiene should be maintained. In the case of superficial infections, the skin should be kept clean and dry, and care should be taken to avoid contact with other parts of the body. If someone in the household has a superficial fungal infection, bed sheets, towels, floors, shower stalls, and other contact surfaces should be washed with hot water and disinfected after use.



Duke, James A., Michael Castleman, and Alice Feinstein. The Green Pharmacy. Emmaus, PA: Rodale Press, 1997.


Farschian, M., R. Yaghoobi, and K. Samadi. "Fluconazole Versus Ketoconazole in the Treatment of Tinea Versicolor." Journal of Dermatologic Treatment 13 (June 2002): 73-76.

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Lipozencic J., M. Skerlev, R. Orofino-Costa et al. "A Randomized, Double-Blind, Parallel-Group, Duration-Finding Study of Oral Terbinafine and Open-Label, High-Dose Griseofulvin in Children with Tinea Capitis Due to Microsporum Species." British Journal of Dermatology 146 (May 2002): 816-823.

Weinstein, A., and B. Berman. "Topical Treatment of Common Superficial Tinea Infections." American Family Physician 65 (May 15, 2002): 2095-2102.


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Merck & Co., Inc. The Merck Manual of Diagnosis and Therapy.

Patience Paradox

Rebecca J. Frey, PhD

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Fungal Infections


Fungal infections of the skin are among today's most common infectious diseases, and they occur worldwide. Superficial fungus infections fall into three broad categories: the dermatophytes (ringworm), tinea versicolor, and cutaneous candidiasis (yeast infection).

Tinea Corporis (Ringworm of the Skin). The typical lesion is an itchy, round or oval patch of skin with central clearing and a red scaly margin hence the name "ringworm." If it occurs in the groin, it is called "jock itch" or "tinea cruris." If there are only two or three rings of infection, topical therapy with antifungal creams will be sufficient. For widespread infection, oral antifungal pills may be necessary.

Tinea Capitis (Fungal Infection of the Hair). Fungal infections of the scalp are most common in children. The infection presents as round scaly patches of hair loss, often with broken-off stubbly hairs. The infection must be treated with oral antifungal therapies. The prognosis is excellent and shaving the scalp is not necessary.

Tinea Pedis (Fungus of the Feet, or Athlete's Foot). Tinea pedis is the most common type of fungal infection, presenting as itchy, scaling, and/or macerated webspaces. There may be a powdery white scaling of the bottom of the feet. Sometimes the infection presents as blisters on the bottom of the feet. The infection can spread to the groin (tinea cruris). Topical antifungals will cure the webspace infections but oral antifungals are necessary to treat the blistering infections. Afflicted individuals should keep their feet dry and spray their shoes with antifungal sprays.

Tinea of the Nails (Onychomycosis). Toenails are more commonly affected than fingernails. The nail becomes opaque, yellowish, thickened, and crumbly with the accumulation of material under the nail. There may be an associated athlete's foot infection. Oral antifungals are necessary to cure the problem.

Candidiasis (Yeast Infections). Yeast infections occur in closed spaces on the skin, such as the corner of the mouth, under breasts, in armpits, and in the groin. It is a red, moist, and often odorous tender rash, and is more severe in patients taking antibiotics or who have systemic diseases such as diabetes. Heat and sweat aggravate the problem. Candidiasis can also occur in the mouth (oral thrush) or as a yeast vaginitis. Treatment is with topical antiyeast creams and/or oral medication. To prevent recurrence, the area must be kept dry.

Tinea Versicolor. Tinea versicolor presents on the upper trunkas brown spots in the winter and white spots in the summer. It is easily treated by washing the area with antidandruff shampoos, but the therapy must be repeated monthly to prevent recurrence.

Susan Swiggum

John Adam

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Fungal Infections

Fungal Infections

What Are Fungal Infections?

What Are the Common Signs and Symptoms of Fungal Infections?

What Are Some Specific Fungal Infections?

How Common Are Fungal Infections?

Are They Contagious?

How Do Doctors Make the Diagnosis?

Can Fungal Infections Be Treated?

Can Fungal Infections Be Prevented?


Fungal (FUNG-gul) infections are caused by fungi (FUNG-eye) that can grow on the skin, nails, and hair and within internal organs.


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What Are Fungal Infections?

Fungal infections are caused by fungi, tiny microbes* found in soil, air, and water, as well as on plants, animals, and people. There are at least 100,000 species of fungi. The most familiar types are the mushrooms that some people like to eat on pizza, the fuzzy white or blue-green mold that grows on forgotten foods in the back of the refrigerator, and the mildew on the shower curtain. Fungi grow best in warm, moist areas, like a steamy bathroom or the spaces between the toes.

(MY-krobes) are microscopic living organisms, such as bacteria, viruses and fungi.

Relatively few species of fungi cause fungal infections, also called mycoses (my-KO-seez). Those that produce infection can cause two basic types: superficial and systemic infections. Superficial infections are found on the skin, nails, or hair and usually are not serious. Systemic infections take hold inside the body, in individual organs or throughout the body, and can be severe. Systemic infections are more likely to appear in people who have weak immune systems, such as those who have cancer or AIDS*. In these people, the infections can cause chronic* disease and, in some cases, death.

or acquired immunodeficiency (ih-myoo-no-dih-FIH-shen-see) syndrome, is an infection that severely weakens the immune system; it is caused by the human immunodeficiency virus (HIV).
(KRAH-nik) means continuing for a long period of time.

What Are the Common Signs and Symptoms of Fungal Infections?

Superficial fungal infections, such as jock itch, vaginal yeast infection, athletes foot, and ringworm, typically are annoying but not very serious. Their symptoms generally include itchy, dry, red, scaly, or irritated skin. Systemic fungal infections often begin in the lungs and take time to develop. Severe infections occur in people whose immune systems have been weakened, allowing the infection to spread beyond the lungs to other organs. Symptoms of systemic fungal infections depend on which organs become infected and may include respiratory problems, extreme tiredness, coughing, weight loss, fever, night sweats, and headache.

What Are Some Specific Fungal Infections?

Tinea (TIH-nee-uh) is a general term given to a group of superficial fungal infections that affect the nails, feet (athletes foot), groin area (jock itch), scalp, or skin (ringworm). Trichophyton and Microsporum fungi cause these related infections. Ringworm is identified by a red, scaly patch on the skin that looks like an expanding ring around a clearing center. Symptoms of athletes foot include redness and cracking of the skin between the toes, and infected nails on the hands or feet usually look white and appear to be crumbling.

Candidiasis (kan-dih-DYE-uh-sis) is a superficial fungal infection caused by various strains of Candida (CAN-dih-duh) fungi. Candida is a yeastlike fungus often found in the mouth and the lining of the intestinal tract of healthy people. In people with weak immune systems, however, it can grow out of control, leading to an infection. A Candida infection of the mouth and throat is known as oropharyngeal (or-oh-fair-in-JEE-ul) candidiasis (OPC) or thrush, and infection of the vagina is known as vulvovaginal (vul-vo-VAH-jih-nul) candidiasis (VVC) or vaginal yeast infection. OPC can affect newborns, people with AIDS or diabetes*, and other people with weak immune systems. Its symptoms include white, thick patches on the tongue, mouth, and throat. Candida infection commonly occurs in newborns in the form of thrush or diaper rash. VVC is associated with vaginal burning or itching and a thick, cheeselike discharge. In certain situations, Candida can enter the bloodstream and spread to internal organs. This is seen most frequently in hospitalized patients who have weak immune systems and have received antibiotics.

(dye-uh-BEE-teez) is a condition in which the bodys pancreas does not produce enough insulin or the body cannot use the insulin it makes effectively, resulting in increased levels of sugar in the blood. This can lead to increased urination, dehydration, weight loss, weakness, and a number of other symptoms and complications related to chemical imbalances within the body.

A yeast colony, as seen with an electron microscope, looks like growing vegetation. Custom Medical Stock Photo, Inc.

Aspergillosis (as-per-jih-LO-sis) is the name for a variety of systemic infections caused by Aspergillus (as-per-JIH-lus) fungi. If it is inhaled through the mouth or nose, the fungus can cause a mild allergic reaction or a more serious infection of the sinuses* and lungs. Symptoms of aspergillosis vary and may include fever, cough, chest pain, and wheezing. In severe cases, typically seen in people with weak immune systems, the infection can spread to other organs, including the brain, skin, and bones.

(SY-nuh-ses) are hollow, air-filled cavities in the facial bones.

Blastomycosis (blas-toh-my-KO-sis) is a systemic infection caused by the Blastomyces dermatitidis fungus commonly found in soil in the southeastern, midwestern, and south-central United States. The diseases symptoms resemble those of the flu: joint and muscle pain, a cough that brings up sputum*, fever, chills, and chest pain. If it progresses, it can lead to chronic pulmonary* infection, causing permanent lung damage, or widespread disease that affects the bones, skin, and genital and urinary tracts. Blastomycosis leads to death in about 5 percent of patients.

(SPYOO-tum) is a substance that contains mucus and other matter coughed out from the lungs, bronchi, and trachea.
means referring to or pertaining to the lungs.

Cryptococcosis (krip-toh-kah-KO-sis) is a systemic infection caused by the fungus Cryptococcus neoformans, usually found in soil or bird droppings. Typically, the fungus enters the body through the mouth or nostrils when someone inhales fungi spores*, and symptoms of a lung infection, such as cough and chest pain, may develop. Although infection with Cryptococcus usually produces no symptoms or only mild symptoms in healthy people, the infection may spread in people who have weak immune systems. If it spreads to the central nervous system, it can cause inflammation of the membranes covering the brain and spinal cord. This is especially common among people with AIDS.

are a temporarily inactive form of a germ enclosed in a protective shell.

Histoplasmosis (his-toh-plaz-MO-sis) is usually a mild systemic infection caused by Histoplasma capsulatum. This fungus is found in the eastern and central United States in soil that contains bird and bat feces*. When the soil is disturbed, the fungal spores may be inhaled. Histoplasmosis can cause flulike symptoms, including body aches, fever, and cough. Most people who become infected do not experience symptoms, but as with other fungal infections, people with weak immune systems are at risk for severe disease. In those cases, the infection affects the lungs and may spread to the liver*, spleen*, bones, and brain.

(FEE-seez) is the excreted waste from the gastrointestinal tract.
is a large organ located beneath the ribs on the right side of the body. The liver performs numerous digestive and chemical functions essential for health.
is an organ in the upper left part of the abdomen that stores and filters blood. As part of the immune system, the spleen also plays a role in fighting infection.

Sporotrichosis (spo-ro-trih-KO-sis) is a skin infection caused by the Sporothrix schenckii fungus, which is found in soil, thorny plants, hay, sphagnum (SFAG-num) moss, and other plant materials. It enters the skin through a small cut or puncture, such as a thorn might make. Soon, small reddish bumps resembling boils* form around the cut and often ulcerate*. In some cases, infection can spread to other parts of the body, such as the lungs or joints.

are skin abscesses, or collections of pus in the skin.
means to become eroded by infection, inflammation, or irritation.

Friendly Bacteria

Naturally occurring friendly bacteria and fungi live side by side on the human body. Some bacteria help keep fungi in check by preventing them from reproducing uncontrollably and causing disease. From time to time, however, doctors need to prescribe antibiotics to combat not-so-friendly bacteria that cause illness. Most antibiotics kill many types of bacteria, both good and bad, and using them for long periods of time can destroy too many friendly bacteria, allowing fungi to grow unchecked and eventually cause infection. To preserve the bacteria we need, it is important to use antibiotics only when necessary and prescribed by a doctor.

Coccidioidomycosis (kok-sih-dee-oyd-o-my-KO-sis) is a systemic infection caused by Coccidioides immitis, a fungus found in soil in the southwestern United States, Mexico, and South America. Most people with coccidioidomycosis have no symptoms, but 40 percent of patients experience a flulike illness, with fever, rash, muscle aches, and cough. Also know as valley fever, the infection can cause pneumonia* or widespread disease affecting the skin, bones, and membranes covering the brain and spinal cord.

(nu-MO-nyah) is inflammation of the lung.

How Common Are Fungal Infections?

Superficial fungal infections, such as athletes foot and candidiasis, are fairly common. Systemic infections, on the other hand, are rare, appearing in less than one to two people of every 100,000 in the United States, according to the U.S. Centers for Disease Control and Prevention. They are more common in certain populations, such as people with AIDS or those who have had organ transplants.

With the so-called endemic* mycoses, rates of disease are higher in specific geographic areas. For example, coccidioidomycosis occurs in about 15 of every 100,000 people in parts of the southwestern United States (with 10 to 50 percent of the population testing positive for exposure to the fungus). In areas where histoplasmosis is found, up to 80 percent of the population test positive for exposure to Histoplasma capsulatum, but the disease develops only in people with weak immune systems.

(en-DEH-mik) describes a disease or condition that is present in a population or geographic area at all times.

Are They Contagious?

Some fungal infections, such as candidiasis and ringworm, can spread from person to person through contact with the infected area. Most infections, however, develop from fungi found naturally on the human body or in the environment. Many fungi that cause systemic respiratory disease are found in soil or in the droppings of animals or birds. Usually they are inhaled after the soil or droppings are disturbed, sending dust and fungal spores into the air.

How Do Doctors Make the Diagnosis?

Most superficial fungal infections are diagnosed based on their appearance and location. A doctor also may take a skin scraping to examine under the microscope or to culture* in a laboratory. Some fungi glow with a particular color under ultraviolet light, so a doctor may make the diagnosis by shining such a light on the affected area. Systemic infections can be diagnosed by collecting a sample of blood, urine, cerebrospinal fluid*, or sputum to culture.

(KUL-chur) is a test in which a sample of fluid or tissue from the body is placed in a dish containing material that supports the growth of certain organisms. Over time, ranging from hours to weeks, the organisms will grow and can be identified.
(seh-ree-bro-SPY-nuhl) fluid is the fluid that surrounds the brain and spinal cord.

Can Fungal Infections Be Treated?

Most superficial fungal infections are treated at home with antifungal creams or shampoos for 1 to 2 weeks. Oral (taken by mouth) antifungal medication also may be prescribed, if necessary. Some cases of fungal infection last for a while and may need to be treated with medicine for 2 to 4 weeks or even longer. Systemic illnesses often require hospitalization so that the patient can receive intravenous* antifungal drugs and supportive care.

(in-tra-VEE-nus) means within or through a vein. For example, medications, fluid, or other substances can be given through a needle or soft tube inserted through the skins surface directly into a vein.

Can Fungal Infections Be Prevented?

Preventing fungal infections can be difficult, because fungi are everywhere. In general, people who are otherwise healthy rarely contract systemic fungal infections. Practicing good hygiene, keeping the skin dry, and changing socks and underwear every day can help prevent superficial skin infections.

See also

Coccidioidomycosis (Valley Fever)

Skin and Soft Tissue Infections



U.S. Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Atlanta, GA 30333. The CDC provides fact sheets and other information on fungal infections through its website.

Telephone 800-311-3435

Website KidsHealth is a website created by the medical experts of the Nemours Foundation and is devoted to issues of childrens health. It contains articles on a variety of health topics, including fungal infections.

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