Cryptococcus neoformans and gattii are fungi that most commonly infect people with immunodeficiency, especially AIDS, which is highly prevalent in Africa. Cryptococcus is the final cause of death in perhaps 25% of AIDS patients and preventative treatment is sometimes used if the lymphocyte count is too low.
It is an opportunistic fungus, with similarities to pneumocystis carina, which is discussed in a previous entry.
The areas in the body most commonly affected are the lungs, the skin, and the brain. The lung and skin, being exposed to the environment, are the most common entry points for the fungus, and the brain is a frequently involved area. Chronic meningitis, where the symptoms include headache, blurred vision, and confusion, is frequently caused by cryptococcus.
Sometimes, in healthy people, the skin can be infected with “pigeon breeders disease”. Pigeon droppings are a very common source of cryptococcus organisms.
Infection In the lung is usually restricted to immunocompromised individuals, who develop cough, shortness of breath, and fever. Pulmonary cryptococcosis is a slowly developing disease, can be mistaken for tuberculosis, and frequently gets into the bloodstream and then into the brain.
Treatment is usually with amphotericin B and flucytosine.
Thrush is an infection of the mouth with an organism called candida albicans. It is most common in the newborn and with young children, but can occur in adults if they have an immune deficiency, use corticosteroid inhalers, are diabetic, or take broad-spectrum antibiotics.
A combined mother–child problem can occur with breast-feeding mothers in the newborn period. The mother’s nipples may become infected, giving it to the baby, and they can pass back and forth. A baby who has thrush is also susceptible to diaper rash caused by candida.
There is a sense of irritation and some pain associated with thrush in the mouth, the diaper area, and the nipples. Thrush appears as cottage cheese-like areas on the throat and tongue.
The normal immunity usually keeps thrush at bay. In a newborn, however, the immune system is not fully developed. Sometimes the hormones of pregnancy facilitate thrush in the mother. Diabetes and smoking can also allow thrush.
Sometimes the thrush infection will go down into the swallowing tube, the esophagus, and produce inflammation. This can cause pain on swallowing, and is most common in AIDS and other immunodeficiency states.
Treatment of surface candida infections like throat is usually with Mycostatin– containing mouthwashes or creams. If it spreads beyond the surface, however, you will need more potent medications. Candida albicans is everywhere, and your immunity is your main defense against it.
Keep your immunity as solid as possible naturally, with good sleep, diet and exercise.
Pneumocystis is found in the respiratory tract of most mammals and Man. Pneumonia from this organism was extremely rare or unknown before the advent of AIDS.
When the lymphocyte count of a person with AIDS drops below 500, or especially 200, pneumocystis pneumonia is a frequent complication. Symptoms include cough, fever, rapid breathing, and shortness of breath.. The chest x-ray typically shows a “ground glass” appearance, caused by fluid inside the air sacs and throughout the lung. Treatment is usually with trimethoprim sulfa.
Immunosuppressive therapy is often given for organ transplants and auto immune diseases these days. Patients and doctors should be on the lookout for pneumocystis symptoms in this situation. Even long-term corticosteroids can produce enough immunosuppression to allow pneumocystis to invade the body.
Pneumocystis Jeroveci is the causative organism, and used to be called pneumocystis Carini. Doctors suspect this disease when an immuno-suppressed patient, especially AIDS , has a dry cough, with pneumonia and a very low oxygen concentration, more severe than expected. Fluid taken from the lung shows several organisms in little sacks or cysts.
Treatment is with sulfonamids, if they are tolerated. Cortisone must be given not the same time to prevent a severe reaction from absorption of the dead organisms. Pneumocystis is a yeast-like fungus and is also discussed under opportunistic fungal infections.
The following article will give you more information.
COVID-19 is admittedly a pandemic and has caused much economic and social disruption in the world. Now we learn that it may not be over after a few of weeks of illness. LONG COVID is now an accepted syndrome.
You can tell because of the many clinics for handling it being set up by the NHS in England, and millions in research money being directed towards a solution.
The most disturbing thing to me is that infected but asymptomatic or mildly ill people may get this condition, and have one or more symptoms for a long time .Certainly, those more seriously ill develop long Covid symptoms more commonly.
Long Covid is taking its place with chronic fatigue syndrome, posttraumatic stress disorder and post ICU syndrome as poorly understood conditions. They may in fact be taking place simultaneously, even if they are not identical.
The cause can be due to continuing viral infection in older or immune compromised individuals. Vascular damage is another reason that could account for the widespread involvement of practically any organ system that doesn’t go away after a few weeks.
Structural damage to the alveoli of the lungs and other organs can also play a role, which would account for shortness of breath as a prominent persistent symptom. Although it has not been highlighted in the articles that I have read, auto immunity can also be playing a role in long Covid.
This would go along with The myocarditis rarely caused by the mRNA vaccines; perhaps some of the protein sequences of the spike proteins have similar shapes to some human tissues. Name a symptom, and you’ll probably find it listed among the 50 odd symptoms mentioned in the Wikipedia article on long Covid, which is appended to the end of this article.
The most prominent symptoms include extreme fatigue, mental fog, and shortness of breath. Treatment is mainly supportive and general. After ruminating on this condition, it’s going to be quite a while before Yours truly wants to breathe in other peoples air spaces; I plan to continue masking in public, distancing and avoiding large groups.
That being said, I am planning to go out to eat dinner tonight, and can hopefully be placed at the edge of the room. I will inquire as to the vaccination status of our waiter. The people at my table will all be doubly vaccinated, which is not complete assurance of safety, but will help make me feel relatively comfortable.
I also plan on getting a booster shot as soon as it is available. Hopefully, the vaccine incorporating the special mutations of the delta virus will be soon available. You don’t want to be infected by this nasty, promethian shape-shifter. Take care.
Syphilis is a venereal disease, or STD, that is unusual, unique in many ways. First of all, it is one of the few major diseases to have originated in the Americas, the New World, and carried back to Europe most likely by Columbus; Popularized by “guns germs and steel”, the infectious disease traffic was almost all the other way, most famously smallpox which decimated the Native Americans.
A second unusual characteristic is that it’s treatment(penicillin) is known, cheap, easy, and yet Syphillis infects millions of people yearly, most commonly to be sure in the developing world, but also large numbers in America where is helped by AIDS, and spread by men having sex with men.
A third unusual characteristic is that syphilis can mimic practically any disease. There are three stages. The first stage is a painless ulcer, usually on the genitals. After a few weeks, the second stage develops, showing a widespread rash and other symptoms. After a few more months, problems develop in the heart, brain, or growths ( gummas) in many other areas .
When I was in medical school we used to go to an old peoples home to listen for aortic regurgitation, and observe the neurologic symptoms of syphilis patients. Syphilis is still a cause of aortic insufficiency, if untreated.
Treponema pallidum, The causative agent, is also unusual. It has a very small geome, and has many missing cellular mechanisms, making it dependent upon Homo sapiens, it’s only known Reservoir. The fragile but very active organism will die in a few hours outside of its human host. Like it’s confederate,AIDS, The infection can easily spread from mother to child with devastating consequences. It is one of the major diseases for which pregnant mothers are tested.
Syphilis is one of the best arguments for being monogamous. If this can’t be, remember that syphilis is easily treatable, and that you should report any unusual illnesses to your doctor.
Candida albicans is a ubiquitous yeast that has evolved the ability to stick to mucocutaneous linings, e.g. mucous membranes and skin. When present in the mouth it is called thrush, and on the skin intertrigo, or diaper rash among other names.
Almost everybody is infested by candida in low amounts, as indicated by the common incidence of a whitish membrane (thrush) in the mouth of people who regularly use inhaled corticosteroids for asthma. The Cortisone lowers the resistance, enabling the fungus to grow more profusely. The use of broad-spectrum antibiotics also facilitates the growth of Canada by killing off the competition.
Diabetes is a risk factor that commonly increases difficulties that people have in controlling candida growth in their oral and genital areas. Certainly anything that affects the immune system such as very young or very old age, viral infections especially AIDS, organ transplants, and chemotherapy will increase the incidence of Canada.
Due to it’s widespread presence in the body, Candida albicans is the fourth most common cause of bloodstream infections among hospitalized patients, where it grows on indwelling catheters and other in certain devices, which act as avenues for the yeast to invade the bloodstream.
Candida Auris is a member of the same genus, Candida,that has developed some gain of function mutations to allow it to infect the body much more readily. It is very hard to get rid of, and at least one emergency room has been shut down because of a Candida Auris infestation. Another little trick that it has evolved is resistance to most antifungal agents; The mortality rate of systemically infected people is very high.
The combination of greater infectivity and resistance to treatment makes it formidable indeed, but still it is mainly a problem for immuno suppressed individuals. C. Auris is not as widespread as Candida albicans, and the number of cases is currently nowhere near as great. But if you get it, watch out!
As with so many other problems, it is better not see them. In other words, stay healthy with sleep, diet and exercise.
Coccidioidomycosis, also called Valley Fever, is a silent epidemic in the western hemisphere between 40° north and 40° south. Hot summers and mild winters with an annual rainfall of 10 to 50 cm is typical.
The Fungus grows in the soil that is moist, but the soil must dry out and Be disturbed, such as by digging, and the wind speed must pick up before you can get the arthrospores into the air so that they can be taken into the lungs.
Most infected people have minimal symptoms. Among those infected, some get a fever and a cough and recover promptly. 3 to 5% of individuals develop a chronic infection. Infected patients with a weak immune system can have disseminated coccidiomycosis affecting virtually any tissue in the body.
Notable coccidiomycosis symptoms include a profound feeling of tiredness, fever, cough, headaches, rash, muscle and joint pain. A loss of the sense of smell is also described, raising some confusion with COVID-19.
Coccidiomycosis can cause a characteristic painful bump in front of the lower leg called erythema nodosum. People with a combination fever, joint pain, and erythema nodosum are said to have “desert rheumatism”.
20% of community acquired pneumonia can be due to coccidiomycosis in endemic areas such as Phoenix Arizona and the San Joaquin Valley.
Immunizations have been evaluated for cost-effectiveness, and the results were not encouraging. More recently, A modification of the coccidiomycosis genome which prevents growth and multiplication of the spore has been tried as a vaccine in mice and found effective.
It is planned to try this noninfectious spore on dogs, who are also very susceptible to the disease. Dogs are a good choice because Government restrictions and requirements are not so severe, and because people would do almost anything to protect their animals, promising a good market for the vaccine.
A year ago last spring, my brother had a protracted problem which involves his lungs and even his heart, and was admitted to a hospital in Phoenix. Apparently COVID-19 was ruled out, and Coccidiomycosis was diagnosed. The Doctors declined to give him amphotericin or an Azole, the usual treatments. He recovered, was discharged, and currently is doing well with no residual symptoms.
I was planning to visit him last spring, but I’m glad I stayed home; our immune system‘s are too similar.
Fungi are in the outside air, the inside air, and even the air of isolation units In hospitals. The normal human respiratory tract is able to breathe these fungi in, have them deposited on the mucous membrane surfaces and have no problem. The normal respiratory membranes, with their associated cleansing cilia and normal mucus production are able to sweep the invaders out without sustaining any harm.
Problems arise when the respiratory tract is functionally or structurally abnormal, such as in cystic fibrosis, bronchiectasis and COPD. Immunocompromised conditions have been increasing in frequency with the improvement in medical care in recent years. Intravascular catheters and sensors can provide a resting place for pathogens including fungi, as can cavities, scars and other damage to the lung. The immune system may require suppression to accommodate an organ transplants or ameliorate autoimmune conditions.
Cancers, especially of the hematologic or lymphatic system, such as lymphomas, pose a definite problem. Severe burns and malnutrition may weaken the immune system, as may Viral infections, especially AIDS, and more recently COVID-19. More subtle immune problems may arise with diabetes, Obesity, or even a lack of sleep and exercise.
These and other conditions give the fungal infections the OPPORTUNITY to invade the body, and a few dozen of the thousands of species of fungi proceed to do just that. Opportunistic fungi often have special features, depending upon the species. Most prefer the respiratory tract, and if they get in to the bloodstream can go to their favored spots.
Aspergillus, and coccidiomycosis , for instance, prefer the lung. Mucormycosis often involves the sinuses and eyes. Blastomycosis can involve bone. Sporothrix is often found infecting the skin.
Symptoms depend upon the area involved. Of course if it’s a respiratory tract, you have coughing, mucus production, sometimes shortness of breath. With the central nervous system you have headache and confusion. You can see the involvement in the skin.
The number of drugs available to fight fungal infection is fairly limited, and currently involves only three different classes. Many fungi are resistant to one or two of these classes, and can be problematic.
However, fungi do not as a rule spread through the air from person to person, and a true epidemic would be unlikely.