Fungal infections are often classified as opportunistic or primary. Opportunistic infections are those that develop primarily in immunocompromised hosts; primary infections can develop in immunocompetent hosts. Fungal infections can be systemic or local. Lokae fungal infections typically affect the skin (skin infections caused by fungi), oral cavity (stomatitis) and / or vagina (Candida vaginitis) and come in normal and immunocompromised hosts in front.
(Skin infections caused by fungi.) Fungal infections are often classified as opportunistic or primary. Opportunistic infections are those that develop primarily in immunocompromised hosts; primary infections can develop in immunocompetent hosts. Fungal infections can be systemic or local. Lokae fungal infections typically affect the skin (skin infections caused by fungi), oral cavity (stomatitis) and / or vagina (Candida vaginitis) and come in normal and immunocompromised hosts in front. Opportunistic fungal infections Many fungi are opportunists and are, except in an immunocompromised host, usually not pathogenic. There are many reasons for an immune deficiency, u. a. AIDS, azotemia, diabetes mellitus, lymphoma, leukemia, and other hematological tumors, burns, therapy with corticosteroids, immunosuppressants or anti-metabolite. In patients who spend more than a few days in the ICU, it may be due to medical procedures, underlying diseases and / or malnutrition come to immune deficiency. Typical opportunistic systemic fungal infections (mycoses) are candidiasis aspergillosis (mucormycosis, aspergillosis) Fusariosis Systemic fungal infections in severely immunocompromised patients often manifest themselves clinically acute with rapidly progressive progressive pneumonia, fungaemia or signs of extrapulmonary dissemination. Primary fungal infections These infections usually arise from the inhalation of fungal spores, which can lead as a primary manifestation of infection in a localized pneumonia. In immunocompetent patients systemic fungal infections typically run chronic; Disseminated fungal infections with pneumonia and septicemia are rare and proceed if there is damage to the lungs, slowly continued. Until medical help sought or a diagnosis is made, it can take months. In such chronic fungal infections occur rarely pronounced symptoms, but it may include fever, chills, night sweats, anorexia, weight loss, malaise and depression occur. Various organs may be infected, resulting in symptoms and disorders. Primary fungal infections may have a characteristic geographic distribution, which is particularly true on endemic mycoses caused by certain dimorphic fungi. For example, coccidioidomycosis: Primarily in the southwestern United States and northern Mexico limited histoplasmosis: Occurs mainly in the East and Midwest on blastomycosis: limited to North America and Africa paracoccidioidomycosis (formerly, South American blastomycosis): on this continent confined traveler In However, a disease can manifest at any time after returning from endemic areas. When fungi spread from a primary focus in the lung, may occur following characteristic manifestations: cryptococcosis: Typically chronic meningitis Progressive disseminated histoplasmosis: Generalized involvement of the reticuloendothelial system (liver, spleen, bone marrow) blastomycosis: Single or multiple skin lesions or participation prostate coccidioidomycosis: bone and joint infections, skin lesions and meningitis diagnosis cultures and stains Serological tests (especially for Aspergillus, Blastomyces, Candida, Coccidioides, Cryptococcus and Histoplasma) histopathology If doctors suspect an acute or chronic primary fungal infection, they should have a detailed trip – and grant residence history to determine whether patients were exposed to certain endemic mycoses, perhaps years earlier. Pulmonary fungal infections must be distinguished from tumors and chronic pneumonia due nichtfungaler pathogens such as mycobacteria (including TB). It is obtained for a cultural and histopathological examination on fungi and mycobacteria material. Sputum samples may be sufficient, but occasionally a bronchoalveolar lavage, transthoracic needle biopsy or even surgery are required to obtain acceptable material. Fungi that cause primary systemic infections are easily recognized by their histopathological appearance. However, it can be difficult to identify the specific fungus, and usually requires a fungal culture. The clinical significance of positive sputum cultures can upon detection kommensalischer exciter (z. B. Candida albicans) or fungi, which are ubiquitous in the environment (eg., Aspergillus sp.), Unclear be. Therefore, other evidence may (z. B. host factors such as immunosuppression, serological evidence, tissue invasion) may be required to assist in diagnosis. Serological tests can be used to verify many systemic mycoses are when culture and histopathology unavailable or unhelpful, although provide little definitive diagnosis. Among the particularly useful tests include the following: measuring the pathogen-specific antigens, especially from Cryptococcus neoformans, Histoplasma capsulatum and Aspergillus sp (an occasional cross-reactivity with other fungi have been found for each of these serological tests) serum ?-glucan in invasive candidiasis and for Pneumocystis jirovecii infections often positive the complement fixation test (CFT) and newer Enzymimmunoessays for antibodies to Kokzidioidomykosen that are sufficiently specific and not evidence of rising titer require (high titers confirm the diagnosis and have a high risk for extrapulmonary dissemination HIN). Most other tests for antifungal antibodies have low sensitivity, specificity or both of which require a measurement of acute and Verlaufstitern and therefore are of little help for the selection of an appropriate initial treatment.