Question

Discuss why many superficial fungal infections are chronic recurring problems. [5]

Answer 1

There are many reasons to support the recurrence of chronic fungal infection . These reasons are as follows,

1. Increased antifungal resistance - There are two types of resistance developed by the fungal strain. Primary resistance is found naturally among certain fungi without prior exposure to the antifngal agent. Where secondary resistance developes when a suseptible strain exposed to the antifungal agent . Such secondary resistsnce usually dependant upon altered gene expression. When one strain comes in contact with the same antibiotic repetatively in larger dose eventually that starin become resistant to that antibiotic. So in such cases the antimicrobial therapy fails to treat the disease and unknowingly contributes to the resistance.

2. Re-infection - It is also a prominent reason for the recurrence of the infection. If the multiple persons of the same family is infected , there are huge chances for the recurrence the infection to any one of them were completely cured from the infection. Such reinfection occures due sharing of clothes , poor hygiene , tight clothes or simply physical contact.

3. Antifungal misuse - Most of the patients fail to complete the full course of treatment . Such usage of drugs leads to an incomplete elimination of the causitive agent and promotes growth of resistant strain which increases difficulty in treating the infection . So if even there is no resistant strain at the start , such treatment failure and constant use of antifungal eventually select resistant strain that will become predominant in the population.

4. Immuno-comprimisation - In patients who suffer from chronic infection shows defective phygocytosis of the fungal hypea. That means there immune system is unable to kill the pathogen. T.rubrum  is a strain which often causes chronic infections. Also persons with Dibetes are very suseptible to such infections.

5. Use of steroidal creams or drugs - Steroid drugs can helpful for some skin problems and can temporarily reduce symptoms but they don't kill fungus that causes the infection. Steroid can make infection worse beacuse they weaken the skin's defenses. It happenes in case of ringworm . Steroid creams are often used for the treatment of ringworm. In rare cases , steroid creams allow the fungus that causes ringworm to invade deeper into the skin and cause a more serious condition.