Back ground: Non dermatophytic onychomycosis is a fungal infection of fingernails or toenails caused by moulds and yeasts. Onychomycosis is an opportunistic fungal disease and is usually caused due to impaired barrier functions in healthy individuals, for example, trauma in nail. In the last few years the number of cases of non-dermatophytic onychomycosis has greatly increased, mainly in Europe, associated with cases of immunodepression and in immunocompetent subjects. The aim of our study was to evaluate the incidence, the clinic characteristics and predisposing factors of non-dermatophytic onychomycosis. Material and Methods: A total of 1268 patients’ samples including toe and finger nails clippings and subungual debris were collected at the Medical mycology Laboratory of Pasteur Institute of Iran, Tehran from March 2005 through March 2006. Specimens were obtained from clinically suspected fungal infections of toe and finger nail by mycosis, and primary care physicians. The etiologic agents of onychomycosis were established after repeated cultural examinations. All collected specimens were analyzed by direct microscopy and culture. Microscopic examination of these specimens was carried out in potassium hydroxide solution (20%) with demethyle sulfoxide (4%). These specimens were cultured on sabouraud glucose agar with chloramphenicol and sabouraud glucose agar with chloramphenicol and cyclohexamide. Cultures were incubated at 25ºc for up to 28 days and checked twice weekly for growth. Results: The patients with onychomycosis were 410 cases , of whom 47 cases (11.5%) were non-dermatophytic onychomycosis. . We found that Aspergillus spp. were the more responsible etiologic agents of non dermatophytic agents of onychomycosis, resulting in a total of 28 patients (59.6%). The toe nail was more affected (72.3%). Non-dermatophytic onychomycosis were 11.5% of all ungual infections. In our study other causative agents were Acromonium spp., Fusarium spp., Trichosporum spp. Scopolariopsis spp. and Geotrichom spp. Conclusion: In our opinion such studies should be performed in every country in order to determine the major fungal species responsible; such information is extremely useful in the treatment of nail onychomycosis. Early diagnosis and accurate therapy are important for the resolution of onychomycosis. Knowing the exact pathogens is important and has implications in therapy and prognosis.
Full conference title:
9th EUROPEAN CONFERENCE ON FUNGAL GENETICS
- ECFG 9th (2008)