Fungal Infections 101: What You Need to Know from Top to Toe

Fungal infections are a topic that people can find difficult to discuss due to embarrassment and shame. However, they are fairly common and can occur anywhere on our bodies, including within our body systems. This article examines fungal infections for a better understanding of their types, treatment, and prevention methods, in addition to how some are more serious than others. Find out more about fungal infections, from tip to toe. 

Understanding Fungal Infections

Fungal infections are diseases caused by fungi, which are microorganisms that typically live in warm and moist environments¹. There are also endemic fungus that are found in certain geographic locales (e.g. Coccidioidomycosis, cryptococcosis, blastomycosis and penicilliosis, etc). Although mostly found outdoors, fungi can enter indoor environments via air circulation, entryways, and on items or people². Fungi are eukaryotes, which means they are complex cells with a nucleus, unlike bacteria and viruses. When they overgrow in our bodies, a fungal infection occurs. The medical term for fungal infections is mycosis. Most fungal infections are superficial — affecting skin, nails, mucosa and hair. Some are invasive, especially in immunocompromised individuals.

Common Fungal Infections by Body Part

Fungal infections can take place anywhere on the body, but they most commonly begin from and affect the skin. They are more prevalent in areas prone to moisture and begin when spores come into contact with, or are inhaled by us. If fungi get past the skin, they can cause body-wide infections that are more serious.

Skin

Some of the most common fungal infections concern the skin, including athlete’s foot, ringworm and jock itch. These superficial conditions tend to cause skin redness, itching, swelling, peeling, blisters, and scaly skin. While athlete’s foot affects the feet, jock itch usually infects the groin and inner thighs, and ringworm can occur anywhere on the body.

Nails

Ringworm can also cause infection to the nail, as the fungi (dermatophytes) feed on keratin to grow and reproduce³. Discoloured, thick and brittle nails are signs of onychomycosis. According to the US Centers for Disease Control and Prevention (CDC), this disease affects up to 14% of the population with toenail infections being more common⁴. 

Hair

When ringworm affects the hair and scalp, it is known as tinea capitis. More specifically, it targets the scalp and forms red and scaly patches on the head. The itchy rashes can lead to hair loss and balding.

Mouth

A fungal infection in the mouth is often due to an overproduction of candida albicans, a common yeast that normally lives in trivial amounts on our bodies. When there is an overgrowth of this fungus, it can cause issues for areas like the mouth, urinary tract and groin. Oral thrush is the term for a yeast infection of the mouth. White patches or lesions, redness, loss of taste, and a cottony feeling in the mouth are signs of oral thrush. This fungal infection affects more children than adults⁵.

Vagina

Candidiasis of the vagina is more commonly known as a vaginal yeast infection (vulvovaginitis). It happens when too much yeast grows in the vagina, leading to an imbalance of vaginal flora. Common symptoms include itching, swelling, a burning feeling, and redness surrounding the vagina. Thick and white clumps of vaginal discharge are also a distinct sign. It is not uncommon following ingestion of antibiotics or steroids used for treatment of other conditions. 

Lungs 

There are certain fungal infections that can become particularly invasive and attack the lungs. For example, an Aspergillus infection can manifest as aspergilloma, producing a fungal ball in the lung cavity developed from  pre-existing lung disease. Although rare, pulmonary candidiasis may occur in individuals who are immunocompromised or have underlying health conditions⁶.

Systemic Infections

Systemic fungal infections refer to fungal infections that are not localised, but involve a network of tissues, organs or the entire body. They are considered medical emergencies and are life-threatening with high mortality rates⁷, mostly impacting immunocompromised individuals. Blastomycosis, coccidioidomycosis and histoplasmosis are some notable examples of fungal infections that start from the lungs but can become systemic.

Risk Factors and Complications

Certain groups of people are more susceptible to fungal infections. A weakened immune system, caused by chronic illness or long-term use of immunosuppressive drugs and antibiotics, can increase vulnerability to these infections. Moreover, certain lifestyle factors, such as frequent exposure to warm, damp environments, poor personal hygiene, and consistently wearing non-breathable clothing, can raise the risk of contracting fungal infections.

When not addressed and treated promptly, fungal infections can cause permanent damage to the skin, spread to other parts of the body, result in systemic fungal infections, infect others, and even cause death. All of these consequences can severely impact your quality of life, which is why immediate attention and treatment is advised. 

Diagnosis and Treatment 

The diagnosis of fungal infections depends on the location of the infection in the body. Skin and vaginal infections are typically simpler to detect due to their noticeable symptoms, although some tests may still be needed for confirmation. In most cases, your doctor will collect a sample of the affected skin or tissue. For invasive fungal infections, a tissue biopsy and culture are usually required².

Most instances of fungal infections can be treated with antifungal medication, which act by eliminating them and inhibiting their growth. Common routes of administration include topical (lotions, creams), oral (tablets, lozenges) and intravenous (IV drips). Your doctor will recommend the treatment based on your specific condition. For oral medications, completing the full course of medication as prescribed is necessary for effective recovery. 

How to Prevent Fungal Infections

Maintaining proper personal hygiene and keeping the skin clean and dry are usually sufficient to defend against fungal infections. Pay close attention to areas and skin folds that tend to trap moisture, and be sure to clean yourself after sweating or getting dirty. Regularly wash your hands, keep your nails trimmed and clean, and always wear footwear in public places like showers and saunas. Additionally, avoid sharing personal items such as towels. 

When to See a Doctor

Early diagnosis and treatment are crucial to prevent superficial fungal infections from progressing into more serious conditions. Consult a doctor if you experience any signs of a fungal infection, even if they seem minor. This is particularly important for individuals with weakened immune systems.

For more information on fungal infections, visit our page here.

References

  1. Fungal Infections of the Skin. WebMD. https://www.webmd.com/skin-problems-and-treatments/fungal-infections-skin. Accessed September 4, 2024.
  2. ‌Fungal Infections. ID Specialists. https://idspecialists.sg/infections-treatments/fungal-infections/. Accessed September 4, 2024.
  3. Hainer B. Dermatophyte Infections. American Family Physician (AFP). https://www.aafp.org/pubs/afp/issues/2003/0101/p101.html. Accessed September 4, 2024.
  4. Symptoms of Ringworm and Fungal Nail Infections. US Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/ringworm/signs-symptoms/index.html. Accessed September 4, 2024.
  5. Thrush. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/10956-thrush. Accessed September 4, 2024.
  6. Johnston WW, Elson CE. Pulmonary Candidiasis. ScienceDirect. https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/pulmonary-candidiasis. Accessed September 4, 2024.
  7. Rautemaa-Richardson R, Richardson MD. Systemic fungal infections. Medicine. 2017;45(12):757-762. doi:https://doi.org/10.1016/j.mpmed.2017.09.007. Accessed September 4, 2024.