Lemini LA, Tapia AGB, Méndez TLJ, Herrera RBS, Hernández HF

Language: English
References: 28
Page: 174-179
PDF size: 219.03 Kb.

ABSTRACT

Onychomycosis are nail infections that can be caused by dermatophytes, yeasts or molds, representing the most frequent superficial mycosis worldwide. Dermatophytoma is a variety of onychomycosis characterized by forming fungal masses and it is caused by dermatophytes, particularly Trichophyton rubrum. However, other non-dermatophyte filamentous fungi, including Aspergillus sp., have been reported. This clinical variety has been associated to failure to conventional antifungal treatment.
The aim of this work is to present a clinical case of immunocompromised patient due to transplantation protocol, with diagnosis of onychomycosis caused by Aspergillus proliferans and propose the term onychofungoma to refer to onychomycosis caused by non-dermatophyte filamentous fungi forming fungal masses.
Several direct examinations of toenail scales, culture on Sabouraud dextrose agar with and without cycloheximide/chloramphenicol and molecular identification by pcr-sequencing using two molecular markers were performed.
The nail microscopic examination showed multiple clusters of light brown hyphae. In culture numerous colonies of a filamentous fungus, microscopically compatible with Aspergillus sp. developed. The molecular identification and the phenotypic study determined Aspergillus proliferans as the etiological agent of onychomycosis.
Onychomycosis whose microscopic study shows fungal masses must be timely attended to avoid patient life-threatening complications, especially when there are risk factors as immunosuppression in the present case. We propose the term onychofungoma (onycho = referent to nail; fungoma = fungal mass) to refer to onychomycosis cases showing fungal masses formed by non-dermatophytic filamentous fungi.

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