Interdigital athlete's foot. The interaction of dermatophytes and resident bacteria

Abstract

Quantitative cultures in 140 cases of interdigital "athlete's foot" established the following clinical-microbiological correlations. In 39 cases of mild, scaling, relatively asymptomatic variety, fungi were recovered in 84% of cases. As the disease progressed to maceration, hyperkeratosis, and increased symptoms, recovery of fungi fell to 55% in moderately symptomatic and to 36% in severe cases. Symptomatic cases had increasing numbers of resident aerobic organisms, particularly large colony diphtheroids. Experimental manipulations of the interspace microflora in volunteers, monitored with quantitative cultures, demonstrated that symptomatic, macerated, hyperkeratotic process results from an overgrowth of resident organisms if the stratum corneum barrier is damaged by preexisting fungi, while overgrowth of the same organisms in normal, fungus-free interspaces does not produce lesions. These experiments support the conclusion that athlete's foot represents a continuum from a relatively asymptomatic, scaling eruption produced by fungi to a symptomatic, macerated, hyperkeratotic variety that is caused by an overgrowth of bacteria.

One week terbinafine 1% cream (Lamisil®) once daily is effective in the treatment of interdigital tinea pedis: a vehicle controlled study

“…The relatively high mycological cure rate observed with vehicle may be a consequence of an alteration of the microbiological microenvironment in the toe clefts, which may result from application of bland creams. Overgrowth of bacteria in the toe clefts has been shown to produce a negative mycological culture in patients with tinea pedis [15]. Rapid mycological cure is an important aspect of good management of tinea infections, and in particular interdigital tinea pedis, where transmission of infection is so widespread.…”

Causative Organisms of Cellulitis – A Retrospective Study

“…Long term morbidities or frequent conditions could be treated with Benzylpenicillin based on literature studies. [35][36] …”

Growth Inhibition of Trichophyton Species by Pseudomonas aeruginosa

“…2 Maceration, scaling, and fissures result, allowing for overgrowth of bacteria that normally inhabit this interspace. 3 Proliferation of these organisms, which include most prominently Pseudomonas aeruginosa, other gram-negative bacteria (eg, Escherichia coli and Proteus mirabilis), and gram-positive bacteria, leads to an aggressive, painful infection. 4 Once these bacterial species propagate, fungi, which initiated the toe web infection, cannot usually be recovered via culture.…”

“…4 Once these bacterial species propagate, fungi, which initiated the toe web infection, cannot usually be recovered via culture. 3 Therefore, growth of bacteria associated with toe web infections may exhibit fungistatic and/or fungicidal properties. In fact, P aeruginosa has been shown to inhibit both Candida albicans and Aspergillus fumigatus in vitro.…”