Non-dermatophytic Molds as Agents of Onychomycosis in Izmir, Turkey – A Prospective Study

Abstract

The purpose of this study was to determine the prevalence of causative non-dermatophytic filamentous fungi in onychomycosis. Totally 1,222 (1,222 x 3 = 3,666) samples of nail scrapings from 1,146 patients (from 76 patients two specimens: both from finger- and toe-nails) with prediagnosis of onychomycosis sent to the Mycology Laboratory from the Clinic of Dermatology, Ege University Hospital, Izmir, Turkey, July 2001-December 2003, were prospectively studied with conventional mycological procedures. The set criteria for the diagnosis of onychomycosis due to non-dermatophytic molds were: (1) Observation of fungal elements in 15% KOH-preparations made from nail scrapings, (2) growth of the same mold in all three consecutive cultures of the specimens taken three times from the same patient with one-week intervals, (3) no growth of a dermatophyte or yeast in three consecutive cultures. As agents of onychomycosis molds were detected in 33 (9%), dermatophytes in 175 (48%), yeasts in 150 (41%), and mixed (two different fungi) in 8 (2%) patients. In cases of mold onychomycosis, 11 (33%) had finger-nail and 22 (67%) toe-nail infection; 25 (76%) were female and 8 (24%) male; and 27 (82%) were above 40 years of age. The agents of mold onychomycosis, in order of frequency, were Aspergillus niger (7), Acremonium spp. (6), Fusarium spp. (6), Ulocladium spp. (4), sterile mycelia (2), Alternaria sp. (1), Aspergillus flavus (1), Aspergillus fumigatus (1), Aspergillus terreus (1), Cladosporium sp. (1), Paecilomyces spp. (1), Scopulariopsis sp. (1) and Trichoderma sp. (1). In conclusion, this study showed that non-dermatophytic molds were responsible for nearly 10% of onychomycoses cases attending the dermatology outpatient clinic of a university hospital in Izmir, Turkey. Since molds are common contaminants in the laboratory, cultures from consecutively taken nail scrapings should be made and carefully evaluated in order to diagnose a "mold onychomycosis".

Monoclonal Antibodies to Hyphal Exoantigens Derived from the Opportunistic Pathogen Aspergillus terreus

“…In contrast to its economic importance in biotechnology, A. terreus causes significant losses by spoiling food and agricultural products (2,14,31). Furthermore, A. terreus has been reported as a human pathogen and can cause superficial, cutaneous, and subcutaneous mycoses that affect the nail bed (28), outer ear canal (60), and skin (16). More recently, A. terreus has been associated with postoperative osteomyelitis (43), endophthalmitis (22), and peritonitis (63), and the species has been identified as an emerging opportunistic pathogen in immunocompromised populations (3,4).…”

Onychocryptosis together with onychomycosis due to non dermatophyte molds treated by brace and citric acid

“…However nowadays there is increasing evidence saying non dermatophyte molds are even more prevalent than dermatophytes, one of the reasons of which may be wide use of systemic antifungal agents [3,[5][6][7]. Besides, non dermatophyte molds are getting increasingly resistant to widely used topical and systemic antifungal treatment agents [3,9,10,12].…”

“…Causative fungi were majorly believed to be dermatophytes a few decades ago where non dermatophyte molds and yeasts are accepted to be contaminants and hence would not change treatment plan of patients [4]. However, recently, increasing number of studies show more cases of onychomycosis due to molds and yeasts [3][4][5][6][7][8][9][10].…”

The Antifungal Effect of some 4-Chloro-6-Methoxy-N, N-Dimethylpyrimidin-2-Amine Derivatives Containing a Heterocyclic Compound on the Important types of Fungi

“…[16][17][18] In continuous of our works to synthesized and evaluated some derivative of pyrimidine towards HIV, HCV, many type of bacteria, cyclin-dependent kinase 2 (CDK2) inhibitory activities and monastrol analogues, 19-21 so we herein aim to study the activity of some heterocyclic rings like [1,2,3-thiadiazole, 1,2,3-selenadiazole, benzo[d]thiazol-2-ylthio)] and thiophenyl compounds against some fungi such as Aspergillus terreus and Aspergillus niger. Aspergillus terreus was described as a filamentous fungus that linked with organic detritus decay in the soil rhizosphere, 22 Additionally, A. terreus has been described as a human pathogen and can initiate cutaneous, and subcutaneous mycoses that disturb the nail bed, 23 outer ear canal, 24 and skin. 25 Newly, A. terreus has been documented to be accompanying with postoperative osteomyelitis, 26 endophthalmitis and peritonitis.…”