Descriptive study of onychomycosis in a hospital in São Paulo

Onychomychosis, a nail fungus infection is the most frequent nail ailment, constituting about half of all nail disorders. It can be caused by dermatophytes, non-dermatophytes, yeasts and Prothoteca spp. Methods include 5407 samples of patients with suspected onychomycosis, studied from January 2002 to December 2006, by direct mycological examination and fungi culture. The diagnosis of onychomycosis was confirmed in samples from 3822 direct mycological and/or culture positive. The diagnosis was established by culture for fungi. Among the 1.428 identified agents, the dermatophytes were responsible for 68.6% (N = 980) of cases, followed by yeasts with 27.6% (N = 394), non-dermatophytes fungi with 2.2% (N = 31), Prothoteca spp with 0.1% (N = 2), and associations with 1.5% (N = 22). Females were more affected, with 66% (N = 2527) of cases, and the most affected age group ranged from 31 to 60 years of age (median 47 years). Fungal microbiota is often changed in the world, both quantitatively and qualitatively, and is affected by several environmental factors. Thus, the periodic review of the composition of this microbiota is important to evaluate the epidemiology and thus proportion a better therapeutic response.

Micosis superficiales en atletas de la Facultad de Ciencias de la Educación, Universidad de Carabobo / Surface mycosis in athletes from the School of Education, University of Carabobo

Las dermatofitosis constituyen uno de los problemas de salud más frecuente a nivel mundial, con mayor incidencia en países tropicales y subtropicales, más frecuentemente en el sexo masculino. Los atletas están en constante predisposición a sufrir de infecciones micóticas por la variabilidad de las condiciones individuales así como ambientales. El objetivo fue determinar la prevalencia de los agentes etiológicos causantes de micosis superficiales en los atletas de la Facultad de Ciencias de la Educación de la Universidad de Carabobo. La muestra estuvo representada por 71 atletas de diferentes disciplinas que presentaban lesiones sospechosas de micosis superficiales en piel y uñas, realizándoles un examen directo con KOH, Cinta adhesiva, cultivo en Agar Lactrimel. Los aislados obtenidos se les practicó un examen directo con azul de lactofenol y microcultivo para identificar el agente etiológico. Se encontró en los atletas 63,4% de lesiones por dermatofitos identificando las especies T. rubrum (23,9%), T. mentagrophytes (19,7%) y E. floccosum (19,7%) y 36,6% de lesiones por levaduras identificando Malassezia furfur (29,6%) y Malassezia ovalis(7,1%) siendo el sexo masculino el más afectado. Estos hallazgos son relevantes debido a que estos agentes se aprovechan de condiciones desfavorables para colonizar y ocasionar lesiones que pudiesen disminuir el rendimiento deportivo del atleta.

Dermatophytosis is one of the most common health problems worldwide, with greater incidence in tropical and subtropical countries, most often in males. Athletes are constantly predisposed to suffering from fungal infections due to the variability of individual and environmental conditions. The objective was to determine the prevalence of etiological agents causing superficial mycosis in athletes from the School of Educational Sciences at the University of Carabobo. The sample was represented by 71 athletes from different disciplines that had lesions suspected of being surface mycosis on skin and nails; a direct examination was made with KOH, adhesive tape and cultivation on Lactrimel agar. The obtained isolates were examined directly with lactophenol blue and microculture to identify the etiologic agent. It was found that 63.4% of the athletes had lesions by dermatophytes, identifying the species T. rubrum (23.9%), T. mentagrophytes (19.7%) and E. floccosum (19.7%); in 36.6% of lesions, the yeast Malassezia furfur (29.6%) and Malassezia ovalis (7.1%) were identified; males were the most affected. The findings are relevant because these agents take advantage of adverse conditions to colonize and cause lesions that could decrease athletic performance.

Características clínicas, epidemiológicas y microbiológicas de la onicomicosis en un laboratorio de referencia, Manizales (Caldas), 2009 / Clinical, epidemiological and microbiological characteristics of onychomycosis in a reference laboratory in Manizales (Caldas), 2009

Objetivo. Establecer las características clínicas, epidemiológicas y microbiológicas de la onicomicosis en pacientes mayores de 16 años de Manizales. Método. Se llevó a cabo un estudio descriptivo y prospectivo de 232 pacientes con diagnóstico clínico de onicomicosis, remitidos de los diferentes centros de atención de Manizales en el año 2009. Se recolectaron las muestras y se hizo examen directo en KOH al 20 % y en dimetil-sulfóxido al 36 %, cultivo en agar Sabouraud y agar Sabouraud con antibióticos, en todos los casos. Se identificaron los 146 aislamientos obtenidos con métodos específicos para dermatofitos, levaduras y mohos. Resultados. La presentación más frecuente fue la forma distal de la enfermedad, la cual se asoció con mayor frecuencia a calzado oclusivo y predominio del sexo femenino; el número de casos de lesiones ungulares indicativas de onicomicosis fue menor en mayores de 70 años de edad; los agentes más frecuentemente aislados fueron Trichophyton rubrum (26,7 %), Fusarium spp. (14,4 %), T. mentagrophytes (11 %), Candida tropicalis (11 %), Candida krusei (6 %) y Geotrichum candidum (6 %). Conclusiones. La onicomicosis es más frecuente en las mujeres de Manizales. Hay una alta frecuencia de aislamientos de hongos no dermatofitos. Trichophyton rubrum fue el hongo dermatofito más frecuentemente aislado. La frecuencia de personas con examen directo o cultivo positivo es mayor de 70 % en todos los grupos de edad, y la edad no se encontró como un factor de riesgo para la enfermedad.

Introduction: Onychomycosis is the leading cause of nail disease and represents 30% of superficial fungal infections. The fungi that cause the condition vary according to geographic location and individual risk factors. Even with the identification of the causative agent, the treatment failure rate is high. Objective: To establish the clinical, epidemiological and microbiological causes of onychomycosis in patients over 16 years old in the city of Manizales. Materials and methods: A prospective descriptive study in 232 patients with clinical diagnosis of onychomycosis sent from different medical centers of Manizales in 2009. A sample collection, direct examination with KOH 20% and dimethyl sulfoxide 36%, culture in Saboreaud agar with antibiotics in all cases were performed. Identification was done for the 146 obtained isolates with specific methods for dermatophytes, yeasts and molds. Results: The most common presentation of the disease was the distal; the disease is more commonly associated with occlusive footwear, for females. The clinical manifestations was the type subungual distal in patients over 70 years old; the most frequently isolated agents were Trichophyton rubrum (26.7%), Fusarium spp (14.4%), T. mentagrophytes (11%), Candida tropicalis (11%), Candida krusei (6%) and Geotrichum candidum (6%). Conclusions: There was a female predominance of onychomycosis in Manizales and a the high frequency of non-dermatophyte fungi; T. rubrum was the most frequently isolated dermatophyte; the frequency of patients with KOH or positive culture is higher than 70% in all age groups. It was found that age is not a risk factor for the disease.

Pattern of Onychomycosis - A RIMS Study.

Onychomycosis is a fungal infection of nails caused by dermatophytes, yeasts or non-dermatophytes moulds. In this study, 500 patients suspected of having onychomycosis reffered from the out patient department (OPD), Dermatology, Regional Institute of Medical Sciences(RIMS) Hospital Imphal Manipur during the period from January 2007 to December 2008 were processed in the Department of Microbiology RIMS. Nail clippings or scrapings depending on the variety of onychomycosis were collected with sterile blades under all aseptic measures. Specimens were put up for 10% KOH mount, fungal cultures on two sets of SDA (Sabouraud‘s dextrose agar) incorporated with antibiotics and lactophenol cotton blue preparation (LCB) from the cultures and examined microscopically. Slide cultures were also put up if necessary. Out of 500 samples processed, a total of 444(88.8%) were positive for the various fungi. The positive fungi were dermatophytes 258(58.1%), non-dermatophytes 139(31.3%), yeasts and yeast-like 17(3.8%) and mixed fungal isolates 30 (6.7%). Of the 230 males and 270 females studied,193(83.9%) males and 251(92.9%) females respectively were positive for various fungi causing onychomycosis. Maximum number of suspected cases were in the age group of 21-30 years.Among the dermatophytes, Trichophyton species (spp.) 250(50%) was the commonest isolate followed by Epidermophyton spp. 8(1.6%). Among the non-dermatophytes, Aspergillus spp. 70(14%) was the commonest followed by Penicillium spp. 24(4.8%), Acremonium spp. 9(1.8%), Fusarium spp. 8(1.6%), Curvularia spp. 7(1.4%), Alternaria spp. 5(1%), Scopulariopsis spp. 4(0.8%), Cladosporium spp. 4(0.8%), Nigrospora spp. 2(0.4%), Mucor spp. 1(0.2%), Paecilomyces spp. 1(0.2%), Pseudallescheria spp. (0.2%), Rhizopus spp. 1(0.2%), Verticillium spp. 1(0.2%), Exophiala jeanselmei 1(0.2%). Among the yeast and yeast-like i.e. Candida spp. 15, Geotrichum spp. 1, Rhodotorula spp. 1 were 17(3.8%), mixed fungal isolates 30(6.7%), respectively. Reports were given to the patient for follow up and treatment. Health awareness and suggestions were given for prevention and further spread of onychomycosis.