Fungal Skin Infections: Diagnosis and Antifungal Therapy Monitoring (Nursing)

00:00 Now, let's take a look at how fungal skin conditions are diagnosed.

00:05 When a fungal infection is suspected, but maybe the diagnosis is unclear or the condition is treatment resistant, healthcare providers may use several diagnostic methods.

00:14 I want to just talk about three of them.

00:16 The first one is a KOH preparation.

00:19 Now this involves a skin scraping and the skin scraping is treated with potassium hydroxide and then it's examined under a microscope that'll help identify the fungal elements.

00:29 You could also do a fungal culture.

00:31 Now this takes longer, could be up to like three weeks, but a fungal culture can identify the specific fungal species that's causing the infection, and obviously that's going to help guide the therapy in resistant cases.

00:43 Now the third one is a wood slam.

00:45 Now this has limited utility for dermatophytes because only certain species, mainly the microsporum, will actually fluoresce under ultraviolet light.

00:54 So that one is not as useful for all cases.

00:58 Now you as a member of the healthcare team, you likely may assist with obtaining samples for these tests, so it's important to understand how they're collected and what they tell us about your client.

01:08 Another important function as a member of the healthcare team is to monitor for the efficacy and toxicity of the treatment plan.

01:16 So when you're monitoring antifungal therapy, these are things I want you to keep in mind.

01:20 First, you're going to need baseline testing, liver function tests, CBC, etc., before initiating the treatment.

01:28 Now you're going to follow the appropriate monitoring schedules for different medications and we'll talk a little bit more about those later on in the series.

01:34 You're going to be watching for signs and symptoms that require immediate discontinuation of the meds.

01:39 These are signs of toxicity.

01:41 And you're going to also work with the team as you adjust therapy as needed based on clinical response and your monitoring results.