A rare case of onychomycosis in all 10 fingers of an immunocompetent patient

Banu, Asima; Anand, Mridu; Loganathan, Eswari

doi:10.4103/2229-5178.120649

Cited by 14 publications

(13 citation statements)

References 4 publications

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“…This is mainly because Aspergillus species do not spread to the surrounding skin like other fungal species that cause nail infections. [ 20 ] Aspergillus onychomycosis starts at the tip of the underside of the nail, where spores get accumulated, and the infection spreads toward the cuticle and the nails become thick, discolored, and flaky. [ 19 ]…”

Section: Discussionmentioning

confidence: 99%

Aspergillus species: An emerging pathogen in onychomycosis among diabetics

Wijesuriya

Kottahachchi

Gunasekara

et al. 2015

Indian J Endocr Metab

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Introduction:Approximately, 33% patients with diabetes are afflicted with onychomycosis. In the past, nondermatophyte molds have been regarded as opportunistic pathogens; recently, Aspergillus species are considered as emerging pathogens of toenail infections. In Sri Lanka, the prevalence of Aspergillus species in onychomycosis among diabetics is not well documented.Objective:To determine the proportion of Aspergillus onychomycosis, risk factors and knowledge among diabetics.Materials and Methods:This was descriptive cross-sectional study. Three hundred diabetic patients were included. Clinical examinations of patients’ toenails were performed by a clinical microbiologist. Laboratory identification was done, and pathogens were identified to the species level by morpho-physiological methods. All inferential statistics were tested at P < 0.05.Results:Among clinically suspected patients, 85% (255/300) were mycologically confirmed to have onychomycosis. Aspergillus species were most commonly isolated n = 180 (71%) followed by dermatophytes, yeasts, and other molds n = 75 (29%). Of the patients having Aspergillus onychomycosis, 149 (83%) were in the > age group. In men, Aspergillus onycomycosis was seen in 82%. Among patients who had Aspergillus nail infection, 114 (63%) had diabetes for a period of > years. Among patients who were engaged in agricultural activities, 77% were confirmed to have infected nails due to Aspergillus species.Conclusion:Aspergillus niger was the most common pathogen isolated from toenail infection. Aspergillus species should be considered as an important pathogen in toenail onychomycosis in diabetic patients. Risk factors associated with Aspergillus onychomycosis were age, gender, duration of diabetes, length of exposure to fungi, and occupation.

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Section: Discussionmentioning

confidence: 99%

Aspergillus species: An emerging pathogen in onychomycosis among diabetics

Wijesuriya

Kottahachchi

Gunasekara

et al. 2015

Indian J Endocr Metab

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“…None of the above predisposing factors is specific for Aspergillus spp. However, Aspergillus onychomycosis is seen more among individuals with occupational exposures such as vegetable vendors [ 17 ] and among babassu coconut breakers [ 18 ], diabetics and the elderly [ 19 ]. Some individuals diagnosed with onychomycosis due to Aspergillus spp.…”

Section: Predisposing Factorsmentioning

confidence: 99%

“…An evidence of the non-keratinolytic potentials of these moulds. Aspergillus species growing in nature often produces colourful pigments; therefore, an Aspergillus nail infection may well appear greenish, black, brown or various other shades [ 17 ]. The fungus will not, however, spread to the surrounding skin like some other fungal causes of nail infection [ 17 ].…”

Section: Pathophysiologymentioning

confidence: 99%

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A Review of Onychomycosis Due to Aspergillus Species

et al. 2017

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Aspergillus spp. are emerging causative agents of non-dermatophyte mould onychomycosis (NDMO). New Aspergillus spp. have recently been described to cause nail infections. The following criteria are required to diagnose onychomycosis due to Aspergillus spp.: (1) positive direct microscopy and (2) repeated culture or molecular detection of Aspergillus spp., provided no dermatophyte was isolated. A review of 42 epidemiological studies showed that onychomycosis due to Aspergillus spp. varies between < 1 and 35% of all cases of onychomycosis in the general population and higher among diabetic populations accounting for up to 71% and the elderly; it is very uncommon among children and adolescence. Aspergillus spp. constitutes 7.7–100% of the proportion of NDMO. The toenails are involved 25 times more frequently than fingernails. A. flavus, A. terreus and A. niger are the most common aetiologic species; other rare and emerging species described include A. tubingensis, A. sydowii, A. alliaceus, A. candidus, A. versicolor, A. unguis, A. persii, A. sclerotiorum, A. uvarum, A. melleus, A. tamarii and A. nomius. The clinical presentation of onychomycosis due to Aspergillus spp. is non-specific but commonly distal–lateral pattern of onychomycosis. A negative culture with a positive KOH may point to a NDM including Aspergillus spp., as the causative agent of onychomycosis. Treatment consists of systemic therapy with terbinafine or itraconazole.

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“…Nail infection (Onychomycosis) due to fungi is a communal disease of the fingernails or toenails of dermatophytes, yeasts, and non-dermatophytic molds. Today, Onychomycosis is a major public health case due to its growing incidence and has considerable clinical implications as well as helping as an illness reservoir [1]. The occurrence of nail infection has been described to be 23% through Europe [2] and 20% in East Asia [3].…”

Section: Introductionmentioning

confidence: 99%

Molecular Identification of Fusarium proliferatum from toenails: A case report

Gharib

Tahir

2019

KJAR

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Fusarium is a saprophytic fungus which is broadly disseminated in soil, plant debris and other organic substrates. These fungi can affect indigenous tissue in immunocompromised patients and result in some fungal infections such as Onychomycosis, bone and joint disease, or sinusitis. In this paper, we report a 56-year-old female has Diabetes milletus who established to disseminate Fusarium infection in her left first toenail from the Dermatology Department / Khabat Skin Center, Sulaimani Province, Iraq. To study of these fungi as the true causative agents of nail infection, we describe a PCR/sequencing assay to confirm routinely diagnosis of the infecting fungi in this case with toenail Onychomycosis. Designation of the ordinary laboratory of Fusarium is very challenging because of the septate hyphae of Fusarium are hard to discriminate from those of Aspergillus, which has a more favourable consequence and this time-consuming. Therefore, molecular tools were used for identification of F. proliferatum from this case by amplifying ITS region of rDNA using a pair of universal primers ITS1 and ITS4. Infectious fungal molecular detection advances the select of right antifungal therapy, in that way improving the medication rate of nails infections. DNA sequence analysis and Phylogenetic tree of the amplified ITS-rDNA was used for species identification of this strain of F. proliferatum. For final identification sequencing of DNA has been carried out by [Macrogen Korea] using forward primer ITS1, The obtained consensus of query sequence was compared with the ITS DNA database on the BLAST homepage, aligned and diagnosed strain deposited to the GenBank and we received an accession number (MK112619). The sequence of the F. proliferatum amplicon was aligned using ClustalW and the alignment was used to make phylogenetic analysis using MEGA software version X. To the best of our knowledge, the isolated Fusarium in this paper is the first case of its kind to be sequenced and reported by the molecular method in Kurdistan region of Iraq

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A rare case of onychomycosis in all 10 fingers of an immunocompetent patient

Cited by 14 publications

References 4 publications

Aspergillus species: An emerging pathogen in onychomycosis among diabetics

Aspergillus species: An emerging pathogen in onychomycosis among diabetics

A Review of Onychomycosis Due to Aspergillus Species

Molecular Identification of Fusarium proliferatum from toenails: A case report

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