BACKGROUND:Onychomycosis are caused by dermatophytes and Candida, but rarely by non-
dermatophyte molds. These opportunistic agents are filamentous fungi found as soil
and plant pathogens.OBJECTIVES:To determine the frequency of opportunistic molds in onychomycosis.METHODS:A retrospective analysis of 4,220 cases with onychomycosis, diagnosed in a
39-month period at the Institute of Dermatology and Skin surgery "Prof. Dr.
Fernando A. Cordero C." in Guatemala City, and confirmed with a positive KOH test
and culture.RESULTS:32 cases (0.76%) of onychomycosis caused by opportunistic molds were confirmed.
The most affected age group ranged from 41 to 65 years (15 patients, 46.9%) and
females were more commonly affected (21 cases, 65.6%) than males. Lateral and
distal subungual onychomycosis (OSD-L) was detected in 20 cases (62.5%). The
microscopic examination with KOH showed filaments in 19 cases (59.4%),
dermatophytoma in 9 cases (28.1%), spores in 2 cases (6.25%),
and filaments and spores in 2 cases (6.25%). Etiologic agents: Aspergillus
sp., 11 cases (34.4%); Scopulariopsis
brevicaulis, 8 cases (25.0%); Cladosporium sp., 3
cases (9.4%); Acremonium sp., 2 cases (6.25%);
Paecilomyces sp., 2 cases (6.25%); Tritirachium
oryzae, 2 cases (6.25%); Fusarium sp.,
Phialophora sp., Rhizopus sp. and Alternaria
alternate, 1 case (3.1%) each.CONCLUSIONS:We found onychomycosis by opportunistic molds in 0.76% of the cases and DLSO was
present in 62.5%. The most frequent isolated etiological agents were:
Aspergillus sp. and Scopulariopsis
brevicaulis.