Original article clinico-mycological study of superficial fungal infections in coastal karnataka, india



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ORIGINAL ARTICLE

CLINICO-MYCOLOGICAL STUDY OF SUPERFICIAL FUNGAL INFECTIONS IN COASTAL KARNATAKA, INDIA

Sweta R. Prabhu 1, Vinma H. Shetty 2, Narendra J. Shetty 3, Girish P.N4, B.P. Keshava Rao5, Roshan Ann Oommen6, Kalpana Sridhar M7, Balachandra A. Shetty8



HOW TO CITE THIS ARTICLE:

Sweta R Prabhu, Vinma H. Shetty, Narendra J. Shetty, Girish P N, B. P. Keshava Rao, Roshan Ann Oommen, Kalpana Sridhar M, Balachandra A. Shetty. “Clinico-mycological study of superficial fungal infections in coastal Karnataka, India”. Journal of Evolution of Medical and Dental Sciences 2013; Vol. 2, Issue 44, November 04; Page: 8638-8646.


ABSTRACT: Cutaneous fungal infections are common in coastal Karnataka owing to its tropical and humid climate. The organisms causing these infections commonly are dermatophytes, non dermatophytes and yeasts. This study aims to determine the prevalence of cutaneous mycosis, with their different clinical types and etiological agents, and correlate the findings. A total of 96 patients were included in our study, all of them attending dermatology OPD at a tertiary hospital in Mangalore with clinically suspected tinea corporis, tinea cruris, tinea pedis, tinea capitis, tinea mannum, onychomycosis, candidiasis and pityriasis versicolor. The study revealed male to female ratio being 0.74:1. The leading diagnosis was pityriasis versicolor, the commonest organism isolated was C. albicans; and the commonest site involved is groin and skin flexures. This study emphasizes utility of timely detection of cutaneous fungal infection in preventing transmission and spread of such infections.

KEYWORDS: Fungal infections; Dermatophytes; Pityriasis versicolor
INTRODUCTION: Cutaneous fungal infections have been reported worldwide as being one of the most common human infectious diseases in clinical practice. In spite of therapeutic advances in the last decades, the prevalence of cutaneous mycoses is still increasing.1,2 Surveillance for fungal infections is important to define their burden and trends, to provide the infrastructure needed to perform various epidemiological and laboratory studies, and to evaluate interventions.

Cutaneous fungal infections can be caused by dermatophytes, yeasts and non-dermatophyte moulds, although dermatophytes cause most of the cutaneous fungal infections. The dermatophytes are a group of closely related fungi that have the capacity to invade the keratinized tissue (skin, hair and nails) of humans and other animals to produce an infection, dermatophytosis, commonly referred to as ringworm can be divided into three groups of anthropophilic, zoophilic and geophilic depending on their natural habits and host preferences. 3,4 Fungi in all three categories may cause human infections.5 These organisms, which attack the keratinized tissue of living host, are classified into three genera of Epidermophyton, Trichophyton and Microsporum.6 The prevalence of dermatophytoses varies in different geographical locations. Dermatophytosis is a common disease in tropical countries due to factors like heat and humidity. The high humidity and temperature provides a fertile ground for the abundant growth of dermatophytes. Over the last 3 decades, an increasing number of non- dermatophyte filamentous fungi have been identified as agents that cause skin and nail infections, producing skin lesions similar to those caused by dermatophytes.7,8 Other fungi commonly causing superficial mycosis is Malassezia furfur, a lipophilic fungus that affects the skin and hair causing diseases like dandruff, pityriasis versicolor, tinea circinata and seborrhoeic dermatitis.9 This study aims to determine the prevalence of cutaneous mycosis, with their different clinical types and etiological agents, and correlate the findings.
MATERIALS AND METHODS: 96 patients with clinical features of superficial fungal infections attending Dermatology OPD in a tertiary hospital in Coastal Karnataka were enrolled in our study. Samples from clinically diagnosed cases of superficial fungal infections were subjected to direct microscopy and culture. Direct microscopic examination was done using 10% potassium hydroxide (KOH) for skin scrapings and 40% KOH for hair and nail specimen. For culture, specimen was inoculated on two sets each of antibiotic incorporated Sabouraud’s Dextrose Agar at 25̊ C, one with 0.05 mg/ml chloramphenicol and another with 0.5mg/ml of cycloheximide along with 0.05 mg/ml chloramphenicol. For isolation of Malassezia furfur Sabouraud’s dextrose agar with chloramphenicol, layered with olive oil was used.
RESULTS: Among the 96 patients enrolled in our study, 41 (42.7%) were males and 55(57.3%) were females. The male to female ratio being 0.74:1. Majority of the patients were in the age group 30-45 yrs with 33 patients (34.37%); 28 were in the age group of 15-30 yrs(29.16%); 27 were in the age group of >45 yrs (28.12%); east amount of patients were in the age group 1-15 yrs with 8 patients (8.33%).Mean age was 36 yrs. The standard deviation is 14.0608.


Age (in years)

Male

Female

Total

1-15

5

3

8

15-30

20

8

28

30-45

7

26

33

>45

9

18

27

Total

41

55

96

Table 1: Age and sex distribution



Graph 1: Age and sex distribution


Fungal infection

No. of patients

Percentage

Candidiasis

18

18.75

Pityriasis versicolor

30

31.3

Tinea corporis

04

4.2

Tinea cruris

13

13.5

Tinea capitis

02

2.1

Onychomycosis

11

11.4

Tinea pedis and T.manuum

18

18.75

Total

96

100

Table 2: Frequency of various clinical presentations

among cutaneous fungal infections








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