ABSTRACT
Onychomycosis is caused by dermatophytes usually, but some species of nondermatophytic molds and yeasts are also associated with invasion of nails. Aspergillus sydowii is a nondermatophytic mold which is opportunistic filamentous fungus in all environments. We report a case of onychomycosis caused by A. sydowii in a 65-year-old male. The patient showed yellowish discoloration with hyperkeratotic change on the distal and lateral portion of both great toenails. Direct microscopic examination of scraping on the potassium hydroxide preparation revealed dichotomous septate hyphae and repeated cultures on Sabouraud dextrose agar showed the same blue green velvety colonies. Biseriate phialides that cover entire vesicle with conidial structure resembling Penicillium were shown in the slide culture. The DNA sequence of internal transcribed spacer (ITS) region of clinical sample was 99% match to that of A. sydowii strain XWSFJJ1 (GenBank accession number FJ461692). We confirmed A. sydowii by KOH mount, colony, light microscopic morphology and DNA sequence analysis. The patient was treated with 250 mg oral terbinafine daily and topical 5% amorolfine nail lacquer for 3 months.
Subject(s)
Aged , Humans , Male , Agar , Arthrodermataceae , Aspergillus , Base Sequence , Fungi , Glucose , Hyphae , Lacquer , Nails , Onychomycosis , Penicillium , Potassium , Sequence Analysis, DNA , YeastsABSTRACT
BACKGROUND: The necessity of performing antifungal susceptibility tests is recently increasing because of frequent cases of oral candidiasis caused by antifungal-resistant Candida species. The Etest (BioMerieux, Marcy l'Etoile, France) is a rapid and easy-to-perform in vitro antifungal susceptibility test. OBJECTIVE: The purpose of this study was to determine the minimal inhibitory concentrations (MICs) of antifungal agents by using the Etest for Candida species isolated from patients with oral candidiasis. METHODS: Forty-seven clinical isolates of Candida species (39 isolates of Candida albicans, 5 isolates of C. glabrata, and 3 isolates of C. tropicalis) were tested along with a reference strain (C. albicans ATCC 90028). The MIC end points of the Etest for fluconazole, itraconazole, voriconazole, and amphotericin B susceptibility were read after the 24-hour incubation of each isolate on RPMI 1640 agar. RESULTS: All Candida isolates were found susceptible to voriconazole and amphotericin B. However, all five isolates of C. glabrata were resistant to itraconazole, among which two isolates were also resistant to fluconazole. CONCLUSION: This study revealed that the Etest represented a simple and efficacious method for antifungal susceptibility testing of Candida species isolated from oral candidiasis patients. Therefore, voriconazole and amphotericin B should be recommended as effective alternatives for the treatment of oral candidiasis.
Subject(s)
Humans , Agar , Amphotericin B , Antifungal Agents , Candida albicans , Candida , Candidiasis, Oral , Fluconazole , ItraconazoleABSTRACT
Tinea barbae is a dermatophyte infection of the bearded areas of the face and neck. The incidence of tinea barbae has decreased as improved sanitation. We report a case of tinea barbae in a 49-year-old-man, who presented with relatively well-defined erythematous patch with pustules on the upper lip. A fungal culture from tissue of the lesions was grown on Sabouraud's dextrose agar and showed typical Trichophyton mentagrophytes. The nucleotide sequence of internal transcribed spacer for clinical isolate was identical to that of Arthroderma vanbreuseghemii IHEM 4411. The patient was treated with oral itraconazole for 3 months. The skin lesions improved 3 months after treatment, and recurrence has not been observed.
Subject(s)
Humans , Agar , Arthrodermataceae , Base Sequence , Glucose , Incidence , Itraconazole , Lip , Neck , Recurrence , Sanitation , Skin , Tinea , TrichophytonABSTRACT
Tinea barbae is a dermatophyte infection of the bearded areas of the face and neck. The incidence of tinea barbae has decreased as improved sanitation. We report a case of tinea barbae in a 58-year-old-man, who presented with relatively well-defined erythematous pustular plaque on the upper lip. A fungal culture from tissue of the lesions was grown on Sabouraud dextrose agar and showed typical Trichophyton verrucosum. The nucleotide sequence of internal transcribed spacer for clinical isolate was identical to that of Trichophyton verrucosum strain ATCC 10695. The patient was treated with oral itraconazole for 3 months. The skin lesions improved 3 months after treatment, and recurrence has not been observed.
Subject(s)
Humans , Agar , Arthrodermataceae , Base Sequence , Glucose , Incidence , Itraconazole , Lip , Neck , Recurrence , Sanitation , Skin , Tinea , TrichophytonABSTRACT
Scedosporium apiospermum is an asexual state of Pseudallescheria boydii which has been isolated from soil, sewage, and decaying vegetation. It can cause cutaneous infections by traumatic implantation of the contaminant due to penetrating injury. This ubiquitous fungus cause not only mycetoma, but also infections of variety of body sites including the skin. The localized skin infection due to this organism is much rare than mycetoma. We report a case of cutaneous S. apiospermum infection occurred in 80-year-old male. The skin lesion was manifested by a 8.0 x 4.0 cm-sized erythematous plaque with pustules and crusts on the dorsum of right hand. The fungal culture from the biopsy specimen on Sabouraud's dextrose agar showed white to gray colored cottony colonies of S. apiospermum. The nucleotide sequence of internal transcribed spacer for clinical isolate was identical to that of S. apiospermum strain IHEM 23829. The patient was treated with oral fluconazole for 3 months.
Subject(s)
Aged, 80 and over , Humans , Male , Agar , Base Sequence , Biopsy , Fluconazole , Fungi , Glucose , Hand , Mycetoma , Pseudallescheria , Scedosporium , Sequence Analysis, DNA , Sewage , Skin , SoilABSTRACT
Fusarium(F.) species are hyalohyphomycetes isolated from plants, soil and air. Fusarium species can cause disseminated infections with involvement of multiple organs and numerous skin lesions in immunocompromised patients. And they can also cause local skin infections of trauma site. We report a case of localized skin infection by F. oxysporum in a 63-year-old immunocompetent woman. She presented with multiple, mild pruritic, 1.5 x 1.5 cm-sized, erythematous maculopapules on the left cheek after cosmetic procedure 4 months ago. Histopathologically, suppurative granulomatous inflammation, fungal elements were observed in dermis. Fungal culture on Sabouraud's dextrose agar showed rapid growing, whitish, cottony colonies at 25degrees C for 1 week. Numerous fusoid macroconidia were observed in slide culture by light microscopy. The nucleotide sequences of the internal transcribed spacer (ITS) region of clinical sample identical to that of F. oxysporum CID 220 strain (GenBank accession number HQ829117.1). The patient had been treated with itraconazole for 6 months. The skin lesion was improved. There was no recurrence 6 months after treatment.