A Case of Onychomycosis with Acute Paronychia Caused by Fusarium oxysporum / 대한의진균학회지

ABSTRACT

Onychomycosis due to Fusarium species almost always involves the great toe nails, especially those affected by traumatic and dystrophic abnormalities. The combination of proximal subungal onychomycosis with subacute or acute paronychia is the typical finding of nail disease due to Fusarium species. The patient was a 12-year-old Korean boy who presented with tenderness and onychoschizia of right great toenail and painful, erythematous swelling and vesicles on periungual area of the right great toe for 10 days. The patient has been healthy except marked growth retardation of both great toe nails with familian backgrounds. Direct microscopic examination of scraping on the potassium hydroxide preparation revealed fungal elements and repeated cultures on Sabouraud dextrose agar showed the same white colonies. Slide culture revealed abundant, oval shaped microconidia and three to five septated, sickle-shaped macroconidia, which was consistent with Fusarim oxysporum. The nail symptoms showed good response to the systemic therapy with terbinafine 250 mg daily. He is now under observation after 3 months of the systemic therapy.