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Mycosis: Causes, Symptoms & Treatment

Mycosis is a fungal infection that can affect the skin, mucous membranes, nails, or internal organs. Fungal infections are common and usually treatable.

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Things worth knowing about "Mycosis"

Mycosis is a fungal infection that can affect the skin, mucous membranes, nails, or internal organs. Fungal infections are common and usually treatable.

What is Mycosis?

A mycosis (plural: mycoses) is an infection caused by pathogenic fungi. Fungi are microorganisms that naturally occur in our environment – on the skin, in the soil, in the air, and in the gut. Under certain conditions, however, they can grow excessively or penetrate body tissues, leading to disease.

Mycoses are generally divided into two main categories:

Superficial mycoses: Affect the skin, hands, feet, nails, or mucous membranes. Examples include athlete's foot (tinea pedis), nail fungus (onychomycosis), and vaginal candidiasis.
Systemic (deep) mycoses: Affect internal organs such as the lungs, kidneys, or brain. This form occurs mainly in people with weakened immune systems and can be life-threatening.

Causes and Risk Factors

Mycoses are caused by various types of fungi. The most common pathogens include:

Dermatophytes (e.g., Trichophyton, Microsporum): Cause skin fungus, athlete's foot, and nail fungus.
Yeasts (e.g., Candida albicans): Cause mucosal and skin infections such as thrush (candidiasis).
Molds (e.g., Aspergillus): Can cause severe lung infections in immunocompromised individuals.

Common risk factors include:

Weakened immune system (e.g., due to HIV, diabetes mellitus, or chemotherapy)
Long-term use of antibiotics or corticosteroids
Moisture and warmth (e.g., sweaty skin folds, public swimming pools)
Injuries to the skin or mucous membranes
Advanced age or infancy
Hospitalization or the use of catheters

Symptoms

The symptoms of a mycosis depend on the affected body region and the causative fungus:

Skin and foot fungus: Redness, itching, scaling, blistering, and skin cracks between the toes
Nail fungus (onychomycosis): Discoloration (whitish, yellowish, brownish), thickening, and brittleness of the nails
Mucosal candidiasis: White patches in the mouth or on the genitals, itching, and burning
Systemic mycoses: Fever, cough, shortness of breath, and general malaise

Diagnosis

The diagnosis of a mycosis is made through various examinations:

Clinical examination: Visual assessment of the affected body region by a physician.
Microscopic examination: Analysis of skin scales, nail samples, or swabs under a microscope to detect fungal structures.
Fungal culture (mycogram): Cultivation of the pathogen on a special growth medium to identify the exact species.
Blood tests: In suspected systemic mycoses, specific antibodies or fungal antigens are detected in the blood.
Imaging procedures: CT or MRI scans are used when organ involvement is suspected.

Treatment

Treatment depends on the type of mycosis, the causative pathogen, and the severity of the disease:

Antifungals (antimycotics): Key active substances include azoles (e.g., fluconazole, itraconazole, clotrimazole), allylamines (e.g., terbinafine), and polyenes (e.g., nystatin, amphotericin B).
Topical therapy: For superficial mycoses, creams, gels, powders, or solutions are applied directly to the affected area.
Systemic therapy: For extensive or deep mycoses, antifungals are administered as tablets or intravenous infusions.
General measures: Keeping feet dry, wearing breathable clothing, and maintaining good hygiene support healing and prevent relapse.

Prevention

Many mycoses can be prevented through simple hygiene measures:

Wash and thoroughly dry feet regularly, especially between the toes
Wear shower shoes in public pools and showers
Avoid sharing towels, nail scissors, or shoes
Wear breathable clothing and footwear
People with weakened immune systems should attend regular medical check-ups

References

World Health Organization (WHO): Fungal Priority Pathogens List. Geneva: WHO Press (2022).
Pappas P.G. et al.: Clinical Practice Guideline for the Management of Candidiasis – Infectious Diseases Society of America (IDSA). Clinical Infectious Diseases, 62(4), e1–e50 (2016).
Robert Koch-Institut (RKI): Infectious Diseases A–Z – Mycoses. www.rki.de (accessed 2024).

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