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Welcome to December's Case of the Month! This month we'll look at some things that can show up when we examine a case a little more closely. |
THERE'S A FUNGUS AMONG US
HISTORY
Joey was a 7-year old Labrador mix who came to us for a skin problem. For a couple of weeks he'd been itchy, and had developed several crusty patches where he'd lost hair. He had no exposure to other animals.
PHYSICAL FINDINGS
Joey was normal on exam except for several patches where his skin was very irritated and he'd lost hair. They oozed yellowish fluid when the crusts were disturbed.
TREATMENT
Joey's condition was compatible with a bacterial dermatitis, or more simply, a skin infection. We treated him with antibiotics intially. A couple of weeks later, when we would have expected the skin to be healed, he still had several sore areas. To make sure we weren't missing anything, we collected some of the oozing material for a fungal culture. After about a week, we had something growing in the culture, and here's what we saw under the microscope:
Here's a closer view:
Pretty, isn't it? This shows the typical branching pattern (hyphae) of a fungus. The small round objects are spores. In this case, the fungus was a contaminant, which just means it was a normal fungus from the environment not known for causing infections. We kept Joey on antibiotics a little longer, and his skin cleared up completely.
DISCUSSION
Fungi are all over the place, and we're exposed to them all the time. Rarely they can cause different types of infections. Similarly, we're surrounded by bacteria, and the body's normal defenses keep us from getting infections all the time. When we see a skin problem, it can be caused by a number of things:
All of these can look similar, and can occur in combination (e.g. an allergy can irritate the skin, leading to a bacterial infection, which could in turn be complicated by a fungal infection). Fortunately, the answer is often a little more straightforward.
See you next month!
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