Fungal Infections

Description

General measures

Medicine treatment

Referral

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B35.0-6/B35.8-9/B36.0-3/B36.8-9/B40.3/B45.2/B46.3

DESCRIPTION

The skin may be infected by fungi, and the clinical presentation varies with organism, body site infected, and the body’s response to the infection.

GENERAL MEASURES

• Manage predisposing factors, i.e. occlusion, maceration and underlying conditions such as diabetes mellitus, eczema, immunocompromising conditions, etc.
• Advise patient regarding spread of infection and exposure in communal, shared facilities (especially spread of dermatophytes).

MEDICINE TREATMENT

Yeast and dermatophytes (fungal infection of the skin):

• Imidazole, e.g.:
  • Clotrimazole 1%, topical, apply 8 hourly until clear of disease (i.e. for at least 2 weeks after the lesions have cleared).

Pityriasis versicolor: B36.0

• Selenium sulphide (Selenium sulfide) 2.5% suspension, applied once weekly to all affected areas.
  • Allow to dry and leave overnight before rinsing off.
  • Repeat for 3 weeks.

Systemic antifungal therapy

• Topical treatment is generally ineffective for dermatophyte hair and nail infections.
• Systemic therapy may be indicated for immunocompromised individuals with extensive skin infection
• Fluconazole, oral, 200 mg once weekly for 6 weeks.
  • For onychomycosis, 200 mg weekly for 6 months

LoE:IIIb^xv

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Note

Recurrent infections may occur if repeat exposure is not prevented.

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REFERRAL

• Non-responsive infections.
• Systemic infections.

Click here to access the pdf.

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Standard Treatment Guidelines and Essential Medicines List for South Africa, Adult Hospital Level, 2020-2024_Version 1.0_07 November 2024

Chapter 4 Dermatology_4.10 Fungal Infections