ABSTRACT
Fusarium species is a representative of hyaline fungi. It is one of the most potent etiologic agent recently reported as emerging pathogen. It may infect immunocompetent and immunocompromised individuals and cause disseminated disease. Three cases of toenails onychomycosis due to Fusarium solani are reported. The same fungus was isolated from the patients in more than two repeated specimens. Compatible filaments were also seen by direct microscopy. Three immunocompetent patients were from different origins, reported to have distolateral subungual onychomycosis [DLSO] of the toenails. Patient 1 was clinically cured after three pulses of oral itraconazole treatment. Patient 2 had blackish discoloration plus [DLSO] of the toenails. It was only treated for financial reasons only by topical antifungal agents, which resulted in moderate clinical improvement. Whereas, patient 3 presented with acute paronychia and onychia, was treated by different topical and systemic antifungal therapy. Such treatments resulted with only partial improvements with recurrence. Fusarium rarely causes infection and is a highly resistant fungus to antifungal therapy. Review of literature suggests that patients respond differently to various antifungal treatments. The present cases support the view that systemic antifungal therapy is more successful in the treatment of Fusarium onychomycosis