Fungal infection- Prevention & treatment

Consult a dermatologist. Fungal infection on skin are resistant to Rx & tend to become chronic. A lot of itching will be there. The patient gets tired as infection tends to recur. If its a fungal infection, you can go for
1. Tab. ketoconazole (nizral)1 tab twice a day for a day & then once a day for 3 weeks
2. Tab fluconazole (forcan)150 mg in a dose as mentioned above
Before taking any of these tablets, make sure that you don't have a major liver problem. Both the drugs are hepatotoxic. If you have history of jaundice 2-3 times, its better to do liver function tests ( SGPT,SGOT). These are enzyme levels which may be high if you have any liver disease.
. Griseofulvin is generally preferred for fungal infection of nail bed. Its available in tablet form.
Many antifungal creams are available like -
clotrimazole, fluconazole, ketoconazole ( trade name- forcan, nizral).
. Good hygiene is extremely important & remember not to share towel with anybody. Keep skin dry.
. Fungal infection on skin are more common in groin, underarms, below the breasts in lactating women, etc. This is because of excessive sweating in these areas. Area below the breasts in lactating women, remains wet due to oozing milk. So it should be kept dry.
make it sure that you don't have dandruff. If you have it, try shampoo- Nizral, scalpe, selsun. Remember not to share comb with anybody.
If the dermatologist diagnoses it as psoriasis, pemphigus vulgaris, then Rx is different.

Molluscum contagiosum- An eye infection

Molluscum contagiosum is a highly infectious viral disease seen on eyelids. it is seen as a small, umbilicated nodule.
Its common in HIV infected cases

Tuberculosis- Lung Disease

Tuberculosis is an infectious disease which is especially common in India. Almost every Indian gets exposed to mycobacterium tuberculosis, an organism that causes tuberculosis. Almost every Indian gets exposed to tuberculosis mycobacteria during his / her lifetime.

Why tuberculosis is getting so much importance again?

This is because of increasing number of HIV +ve people. AIDS patients have compromised immunity. So they get manifest tuberculosis more easily than people who have good immunity. In AIDS patients, TB manifestations will be more severe. Resistant strains of organism cause infection

Which people are likely to be immunocompromised?

People who have following diseases are likely to be immunocompromised.

1. HIV, AIDS

2. Cancer

3. Patients on oral or intravenous steroids. These include

a. Patients who have undergone organ transplant surgery,

b. Patients who have immune mediated diseases like systemic lupus erythematosus, polyarteritis nodosa, rheumatoid arthritis, pemphigus

4. Intravenous drug abusers - This is due to risk of getting HIV infection.

Which organs can get affected in tuberculosis?

Tuberculosis can affect many organs. The most common are –

1. Lungs

2. Lymph nodes

3. Gastrointestinal tract

4. Genitourinary system

Tuberculosis of skin

Skin tuberculosis is a form of extrapulmonary TB (TB infection of other organs and tissues) and it can cause cosmetically disfiguring lesions.

Tuberculous chancre

Direct infection of the skin or mucous membranes from mycobacteria results in chancre.

Various forms of Skin tuberculosis

A. TB verrucosa cutis

–

1. This occurs after direct inoculation of TB into the skin in someone who has been previously infected with mycobacteria.

2. Seen as a purplish or brownish-red warty growth

3. Lesions most often occur on the knees, elbows, hands, feet and buttocks

4. Lesions may persist for years but can clear up even without treatment

B. Scrofuloderma

1. Lesions result from direct extension of underlying TB infection of lymph nodes, bone or joints

2. Firm, painless lesions that ulcerate with a granular base

3. May heal even without treatment but this takes years and leaves cosmetically unsightly scars

C. Miliary TB

1. Infection (usually in the lungs) spreads to other organs and tissues via the bloodstream.

2. Skin lesions are small (millet-sized) red spots that develop into ulcers and abscesses

3. More likely to occur in immunocompromised patients, e.g. HIV, AIDS, cancer

4. Prognosis is poor (many patients die even if diagnosed and treated)

D. Lupus vulgaris

1. Persistent and progressive form of cutaneous TB

2. Small sharply defined reddish-brown lesions with a gelatinous consistency (called apple jelly nodules)

3. Lesions persist for years, leading to disfigurement and sometimes skin cancer.

Treatment of cutaneous TB will be covered in next resource

HAART Rx

Highly Active Anti-Retroviral Treatment