1/21. onychomycosis due to exophiala jeanselmei.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.- - - - - - - - - - ranking = 1keywords = fungus (Clic here for more details about this article) |
2/21. Arachnomyces kanei (anamorph Onychocola kanei) sp. nov., from human nails.Five isolates of a slow-growing cycloheximide resistant hyphomycetous fungus were obtained from nail specimens and investigated for their relationship to Onychocola canadensis (teleomorph Arachnomyces nodosetosus), a known agent of onychomycosis. In one patient diagnosed with superficial white onychomycosis, etiology was confirmed by a nail sample showing atypical filaments in direct microscopy, and by a follow-up specimen yielding cultures of the same fungus. A case of mixed infection with aspergillus sydowii was also confirmed after examination of cultures grown from three successive microscopic-positive hallux nail specimens. For other isolates, etiological significance could not be confirmed by repeat sampling or results of direct microscopy were negative or unknown. Mating experiments yielded setose ascomata containing smooth oblate ascospores typical of Arachnomyces species. Phylogenetic analysis of ITS 2 region sequences support the conspecificity of the isolates and their placement within the genus. A. kanei sp. nov. (anamorph O. kanei sp. nov.) is described.- - - - - - - - - - ranking = 1keywords = fungus (Clic here for more details about this article) |
3/21. Onychomycoses due to Microascus cirrosus (syn. M. desmosporus).Microascus cirrosus is very rarely the aetiological agent of onychomycosis. We report two additional cases of toenail infections caused by this fungus.- - - - - - - - - - ranking = 0.5keywords = fungus (Clic here for more details about this article) |
4/21. Scytalidium hyalinum isolated from the toe nail of an Australian patient.The isolation of Scytalidium hyalinum from the toe nail of a patient from Melbourne is reported. This is the first record of the isolation of this fungus from a clinical site in australia. A brief history is given of the occurrence of Scytalidium hyalinum and the related fungus, Hendersonula toruloidea, in tinea pedis and tinea unguium in immigrants to the United Kingdom from tropical countries. attention is drawn to the possible presence of these dermatophyte-like infections in patients in australia.- - - - - - - - - - ranking = 1keywords = fungus (Clic here for more details about this article) |
5/21. Fungal melanonychia: ungual phaeohyphomycosis caused by Wangiella dermatitidis.A 51-year-old female Japanese patient developed black pigmentation affecting both big toe-nails. Direct potassium hydroxide examination of the nail tissue demonstrated clusters of spherical dematiaceous cells, toruloid hyphae, and septate hyphae. Wangiella dermatitidis was repeatedly isolated from the affected toe-nail lesions. This case represents the first documented case of ungual phaeohyphomycosis, 'fungal melanonychia,' caused by the dematiaceous fungus W. dermatitidis. The patient was successfully treated with a topical solution of bifonazole.- - - - - - - - - - ranking = 0.5keywords = fungus (Clic here for more details about this article) |
6/21. erythema nodosum in patients with tinea pedis and onychomycosis.To document association between erythema nodosum and concomitant fungus infection, we studied seven white women seen during a six-year period in our office practice. Five patients are presented. Unilateral erythema nodosum occurred in three patients on the same side as unilateral tinea. Tests with potassium hydroxide (KOH), cultures of nodules on Sabouraud agar and dermatophyte test medium (DTM), skin biopsy, and clinical examination ruled out nodular granulomatous perifolliculitis of Wilson. Lesions simulating erythema nodosum were produced when trichophyton antigen was injected subcutaneously in the lower legs. All nodose and fungal lesions cleared after griseofulvin therapy. Fungus infection of feet or nails should be considered a possible cause of erythema nodosum when no other cause is apparent.- - - - - - - - - - ranking = 0.5keywords = fungus (Clic here for more details about this article) |
7/21. First Italian report of onychomycosis caused by Onychocola canadensis.Onychocola canadensis is a non-dermatophytic mould that has been associated with onychomycosis particularly in temperate climates. Until now, O. canadensis has been isolated from patients in canada (14 cases), new zealand (three), france (nine), UK (four) and spain (two). We describe the first Italian case of onychomycosis caused by this fungus.- - - - - - - - - - ranking = 0.5keywords = fungus (Clic here for more details about this article) |
8/21. Scanning electron microscope imaging of onychomycosis.Although scanning electron microscope technology has been used for more than 60 years in many fields of medical research, no studies have focused on obtaining high-resolution microscopic images of onychomycosis of the toenail caused by trichophyton rubrum in a geriatric population. To provide new insight into the intricate structure and behavior of chronic toenail onychomycosis, we produced three-dimensional images of onychomycosis obtained from two geriatric patients with confirmed growth of T rubrum. The photomicrographs illustrate the pervasive integration and penetration of the fungus hyphal elements, underscoring the clinical difficulty of obtaining rapid treatment of fungal infections in the distal and lateral subungual space of the human toenail. Although the scanning electron microscope may not be a practical diagnostic tool for most physicians, it remains invaluable for the researcher to obtain insight into the spatial orientation, behavior, and appearance of onychomycosis.- - - - - - - - - - ranking = 0.5keywords = fungus (Clic here for more details about this article) |
9/21. malassezia furfur in a case of onychomycosis: colonizer or etiologic agent?The etiologic role of malassezia furfur in onychomycosis is a contentious diagnostic problem because its keratinolytic ability has never been verified. This case report describes the isolation of M. furfur from the infected nails of a child clinically diagnosed with onychomycosis, and discusses the role of this organism as an etiologic agent/colonizer. The patient presented with subungual hyperkeratosis and onycholysis without associated paronychia. Budding yeast cells compatible with M. furfur were repeatedly demonstrated in KOH wet mounts of damaged nails, histopathology of hematoxylin and eosin (H&E) and periodic acid-Schiff (PAS) stained sections showed penetration of fungal elements between deeper layers of keratin, and numerous colonies of M. furfur were isolated on three consecutive occasions from nail specimens collected from different areas of hand and toenail lesions. No evidence of nail invasion by dermatophytic or nondermatophytic filamentous fungi were found by direct microscopy or culture. microscopy and culture were negative following 12 weeks of ketoconazole treatment, which resulted in growth of healthy nail plates with normal beds. We can infer from these observations that M.furfur was an etiologic agent rather than a colonizer in the patient's nails even though direct keratinolytic character of this fungus was not demonstrated.- - - - - - - - - - ranking = 0.5keywords = fungus (Clic here for more details about this article) |
10/21. onychomycosis caused by fusarium proliferatum.fusarium infections in humans are usually opportunistic, but the fungus sometimes infects healthy persons, causing keratomycosis or onychomycosis. onychomycosis is usually caused by F. solani or F. oxysporum. We report the first two cases of onychomycosis caused by F. proliferatum, and discuss methods of diagnosis and effective treatment. Nail samples from the two patients were examined by direct microscopy, cultured, and identified morphologically and genetically as F. proliferatum. Both patients were treated successfully with oral itraconazole, even though the minimum inhibitory concentration of itraconazole was relatively high in Patient 1. This is the first report of F. proliferatum as an agent of onychomycosis. itraconazole may be effective in the treatment of onychomycosis caused by F. proliferatum.- - - - - - - - - - ranking = 0.5keywords = fungus (Clic here for more details about this article) |
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