Understanding Fungal Infection Diagnosis

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Learn how to establish or confirm a fungal infection diagnosis through microscopy and culture of skin, hair, and nail tissue. Find out how Wood lamp and various microscopy techniques help identify fungal infections, such as tinea capitis. Discover the components used to detect dermatophytes and why negative results don't always rule out fungal infection.

  • Fungal infection
  • Microscopy
  • Diagnosis
  • Dermatophytes
  • Tinea capitis

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  1. Fungal infection To establish or confirm the diagnosis of a fungal infection, skin, hair and nail tissue is collected for microscopy and culture (mycology). Exposing the site to long-wavelength ultraviolet radiation (Wood lamp) can help identify some fungal infections of hair (tinea capitis) because the infected hair fluoresces green.

  2. Direct microscopy of skin scrapings and nail clippings The material is examined by microscopy by one or more of these methods: Potassium hydroxide (KOH) preparation, stained with blue or black ink Fluorescent staining Unstained wet-mount Stained dried smear Histopathology of biopsy with special stains, eg, periodic acid-Schiff (PAS). Microscopy can identify a dermatophyte by the presence of: Fungal hyphae (branched filaments) making up a mycelium Arthrospores (broken-off spores) Arthroconidia (specialised external spores) Spores inside a hair (endothrix) or outside a hair (ectothrix). Fungal elements are sometimes difficult to find, especially if the tissue is very inflamed, so a negative result does not rule out fungal infection.

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