Fungal nail infection

Fungal nail infections are most often noticed on toenails and are accompanied by fungal feet infection. Nails can be infected by fungi due to nail injury, nail disease, over-exposure to dampness, closed footwear for long periods and infection from shower rooms, swimming pools or manicure/pedicure salons. Persons who sweat profusely or work in humid moist conditions are more susceptible to nail fungal infections. It is also more common in those suffering diabetes, AIDS or circulation problems.

In most cases, the fungal infection of the nail is due to Trichophyton rubrum. Common mold causes include Neoscytalidium, Scopulariopsis, and Aspergillus. Infected nails appear brittle and lose luster. They might be discolored yellow. The nails might change in shape and loosen out of the bed. Nail fungal infections are treated with Fluconazole griseofulvin, terbinafine or itraconazole. Creams and ointments might be prescribed too. Those suffering fungal infection of the nail must maintain good foot hygiene and wear well-fitting footwear.

Antifungal Medicines

Fungal infections could include conditions like athletes foot, jock itch, candidiasis and ringworm. Based on the infection, these drugs are available as over-the-counter or prescription medicines. Most fungal infections are minor and not life-threatening.

Systemic Fungal infection – deep infection

• Systemic antifungal drugs are medicines that are taken orally or by injection.
  
• Infections that occur inside the body or those that do not clear up after treatment with ointment need to be treated with systemic antifungal drugs.
  
• These drugs are used to treat fungal infections like candidiasis, blastomycosis, aspergillosis and histoplasmosis.
  
• Common list of systemic drugs include Fluconazole (Diflucan), Miconazole (Monistat I.V.) and Ketoconazole (Nizoral).

Topical (Dermatophytic) – superficial infections occurring on the skin

• Topical antifungal drugs are be applied externally to the skin to treat skin infections caused by a fungus.
  
• Creams and liquids are generally the most effective method for treating fungal infections on the skin. They can get into the cracks and crevices where fungi grow.
  
• Powders absorb moisture and are good to use in moist areas of the body.
  
• Common list of topical drugs include Ciclopirox, Clotrimazole, Econazole, Miconazole and Terconazole. Dosage of antifungal drugs depends on the intensity of the infection and the drug.
  

Fungal infections might take time to clear up hence take the medicines for the period as prescribed by the doctor. Continue the course of medication even though the symptoms may subside or even disappear. Pregnant women/lactating mothers need to check with the doctor before use of any medicines. Anti fungal medications are also classified based on the chemical structure, pharmacokinetics, tolerability, spectrum of activity, etc.

Allylamines: Group of synthetic antifungal drugs that are used locally and systemically.

Imidazole derivates: Most of the drugs are used in treatment of local or external infections and rarely used for systemic treatments.

Polyene antibiotics: Mostly used for topical treatment, as absorption of the drug is low, it is not used for systemic treatment

Triazole: proven to be more effective and safe during treatment.

Esophagitis

Esophagitis is a condition where there is inflammation and swelling of the esophagus. Esophagitis is caused by stomach acid reflux, fungal or viral infection of the esophagus, certain medications and weakened immune system. If esophagitis is left untreated, it can lead to ulcers and difficulty in swallowing. This can lead to scarring of the esophagus and a situation where food may stick in the area (dysphagia). Often Hiatus Hernia causes Esophagitis since the distension of the stomach through the diaphragm muscle hampers the draining of food and stomach acid. This results in the damage of the esophageal tissue. Candida yeast infection can develop in the esophagus and lead to esophagitis. It attacks when the immune system is weakened and is treated with anti-fungal drugs.

A person suffering from esophagitis has difficulty in swallowing and nausea and vomiting. There are mouth sores. Heartburn involves acid reflux into the esophagus as a burning sensation with a bitter-tasting liquid that may regurgitate into the mouth. A patient can reduce the symptoms of esophagitis by eating smaller meals and avoiding eating for 2 hours before going to bed. Avoid too much spices and acidic food and beverages. Take small bites and chew food thoroughly before swallowing. Place your head at an elevation while sleeping to prevent regurgitation and stomach acid reflux. Smoking, alcohol, caffeine, chocolate, peppermint and fatty foods can aggravate the condition.

The physician can view the esophagus with an endoscope to look for scarring and inflammation. A biopsy can be taken for diagnosis. A Barium swallow involves use of a special dye to facilitate x-ray of the esophagus and check for abnormalities. Antacids can help in reducing stomach acid reflux. Medication to improve the strength of the LES muscle can help in treating esophagitis. Antibiotics or anti-fungal drugs may be prescribed to treat the infection. Inflammation can be reduced with the help of Corticosteroid medication. Surgery is resorted to in cases where there is a hiatus hernia or to remove the damaged part of the esophagus.