Onychomycosis due to <i>Exophiala jeanselmei</i>

Abstract

Background:Exophiala jeanselmei is a dematiaceous fungus that may cause invasive diseases, particularly among immunocompromised hosts. Most reports mention cutaneous or subcutaneous lesions, but no case of nail involvement due to this fungus has been reported until now. Case Report: A 60-year-old man presented with hyperkeratosis and black coloration of the nails of the two thumbs and the two big toes of 4 years’ duration. He was a renal transplant recipient and had been treated with prednisone and azathioprine. E. jeanselmei was present on direct examination, then isolated in cultures on repeated samplings from all pathologic nails. He was cured after 6 months of treatment with itraconazole. Commentary: We describe the first case of nail infection due to E. jeanselmei. Itraconazole, which provides a broad spectrum of action on fungal species and achieves high levels of active substance in many tissues, including the nails, appeared to be efficient upon such a nail localization of E. jeanselmei.

Clinical and Histological Aspects of Toenail Onychomycosis Caused by <i>Aspergillus</i> spp.: 34 Cases Treated with Weekly Intermittent Terbinafine

“…[1, 2, 3, 4, 5]. But many other moulds that are usually considered common saprophytes can exceptionally parasitize the ungual lamina directly [6, 7]. …”

Multifocal phaeohyphomycosis caused by Exophiala xenobiotica in a kidney transplant recipient

“…In renal transplant recipients, a major series reported a cumulative prevalence of phaeohyphomycosis of about 0.34–0.44% . To our knowledge, no case of phaeohyphomycosis secondary to E. xenobiotica in a kidney transplant recipients has been published previously (Table S1; ).…”

Dematiaceous fungal infections in solid organ transplantation: Systematic review and Bayesian meta‐analysis

“…An additional 246 cases were identified in 28 reports, but they did not meet our inclusion criteria (Table S5). 9,58,80,140,162,165,170–191 Characteristics of cases included in the present analysis are presented in Table 1. Proven fungal infections accounted for 96% (193/201) of cases, six cases were probable, and two cases were possible.…”

“…Six of 201 cases had recent or concurrent nocardiosis. 26,61,102,139,142,148 In addition to cases included in our analysis, we also identified and excluded one case of each of the following syndromes: esophagitis, 174 nasal phaeohyphomycosis, 175 endocarditis, 176 onychomycosis, 177 infection of the submandibular gland, 178 subhepatic abscess, 190 renal allograft infection. 189 One case of concurrent SSTI and pulmonary infection caused by two separate species was identified and excluded.…”