Comparison of direct microscopy, culture and calcofluor white for the diagnosis of onychomycosis

Bonifáz, Alexandro; Ríos-Yuil, José Manuel; Arenas, Roberto; Santibáñez, Javier; Fernández, Ramón; Mercadillo-Pérez, Patricia; Ponce-Olivera, Rosa María

doi:10.1016/j.riam.2012.07.001

Cited by 29 publications

(23 citation statements)

References 15 publications

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“…In several previous reports that compared fluorescent methods using CFW and KOH for the diagnosis of onychomycosis, CFW did not have a much better result. Bonifaz et al summarised 33 suspected onychomycosis cases, and the positive rates of CFW and KOH were 57.88% and 66.67%, respectively, which showed a lower result using CFW method. Weinberg et al evaluated 105 suspected onychomycosis cases, and the CFW method showed a 72% positive rate, and the KOH method showed a 60% positive rate, which showed that CFW method was only a little higher than KOH method.…”

Section: Discussionmentioning

confidence: 99%

“…The fluorescent method using CFW (calcofluor white) is a simple, rapid, highly efficient direct microscopy method that has a higher positive detection rate compared with KOH in various superficial fungal infectious diseases . Several studies have compared CFW and other methods to diagnose suspected onychomycosis, but they did not show much better results with CFW . Besides, the biggest disadvantages of CFW are that it diminishes quickly and its relatively bright background, but no alternative fluorescent reagents have been developed and used in the diagnosis of onychomycosis.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Several studies have compared CFW and other methods to diagnose suspected onychomycosis, but they did not show much better results with CFW. 6,7 Besides, the biggest disadvantages of CFW are that it diminishes quickly and its relatively bright back- brightener 85), a popular and widely used fluorescent brightener in wood, washing and dyeing industry in the world, in the detection of fungi in superficial fungal infectious diseases and proved that it had a higher positive rate than the KOH method with statistically significant differences (data not published). Therefore, in this study, we continued to evaluate the positive rate, accuracy and efficiency of FB 85 in the diagnosis of onychomycosis compared with KOH.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of a new fluorescent reagent, fluorescent brightener 85, for the diagnosis of suspected onychomycosis compared with potassium hydroxide

Yue

Wang

et al. 2017

Mycoses

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Onychomycosis is a common fungal infection in dermatology clinics. The commonly used diagnostic method, potassium hydroxide (KOH) direct microscopy, does not have a high-positive detection rate. Therefore, a new diagnostic method is needed to confirm onychomycosis. The objective of this research was to use fluorescent brightener 85 (FB 85), a new fluorescent reagent for fungi detection, and to evaluate this new method based on the diagnostic positive rate, accuracy and efficiency in suspected onychomycosis compared with the KOH method. Subungual debris was collected from clinically suspected onychomycosis cases and divided into two parts. The parts were examined by FB 85 and 10% KOH solution, respectively. In total, 108 patients with suspected onychomycosis were recruited. The positive rates of FB 85 and KOH were 88.9% and 55.6%, respectively. The patients showed significant statistical differences (P < .001). Compared with the KOH method, the FB 85 fluorescent method was an accurate and efficient method with a higher positive rate. This method could increase the diagnostic accuracy and efficiency of onychomycosis detection.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of a new fluorescent reagent, fluorescent brightener 85, for the diagnosis of suspected onychomycosis compared with potassium hydroxide

Yue

Wang

et al. 2017

Mycoses

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“…However, the direct application of PCR‐based methods in clinical samples would allow early and specific diagnosis of fungal diseases and identification of the causative agents . Meanwhile, prior studies have suggested that direct microscopy using fluorescence may be a sensitive technique, which could increase detection rates by 4–22% compared with KOH in the diagnosis of fungal infections …”

Section: Introductionmentioning

confidence: 99%

“…3,4 Meanwhile, prior studies have suggested that direct microscopy using fluorescence may be a sensitive technique, which could increase detection rates by 4-22% compared with KOH in the diagnosis of fungal infections. [5][6][7] A limited number of studies have compared molecular diagnoses and conventional culture in the identification of clinical isolates for the diagnosis of onychomycosis, and most immunofluorescence studies have focused on deep fungal infections and the lack data of onychomycosis. Herein, we present the results of fungal fluorescent staining and internal transcribed spacer (ITS) ribosomal DNA (rDNA) PCR-based sequencing compared with conventional methods (microscopy of KOH mount and culture) for the diagnosis of onychomycosis.…”

Section: Introductionmentioning

confidence: 99%

Comparison of fungal fluorescent staining and ITS rDNA PCR‐based sequencing with conventional methods for the diagnosis of onychomycosis

Bao

Fan

Sun

et al. 2018

Acad Dermatol Venereol

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BackgroundThe current gold standard for diagnosing onychomycosis is direct microscopic examination and culturing. Fungal culture is a time‐consuming procedure, while direct microscopy of potassium hydroxide (KOH) mounts suffers from low sensitivity. More rapid and sensitive methods for the diagnosis of onychomycosis are in high demand.ObjectiveTo establish an effective method for the diagnosis of onychomycosis by assessing the efficacies of fungal fluorescent staining and internal transcribed spacer (ITS) ribosomal DNA (rDNA) polymerase chain reaction (PCR)‐based sequencing.MethodsA total of 204 clinical specimens from patients with suspected onychomycosis were analysed. The gold standard for a true positive sample was positive by KOH, culturing or both methods. All specimens were also tested by fungal fluorescent staining and ITS rDNA PCR‐based sequencing. We compared the detection, sensitivity and specificity for these two methods with conventional methods.ResultsIn total, 126 (62%) and 102 (50%) were detected by fluorescent staining and PCR‐based sequencing, respectively. According to the conventional diagnostic standard, the sensitivity of fluorescent staining and PCR‐based sequencing was 97% and 78%, respectively, and specificities of 89% and 90%, respectively. Use of fluorescence enhanced the sensitivity of direct examination by 12% compared with KOH. PCR‐based sequencing increased the sensitivity by 6% compared with culturing.ConclusionsFluorescence microscopy has a higher sensitivity for the detection of fungi in nail specimens compared with KOH and can be used as a rapid screening tool. PCR‐based sequencing was faster and more sensitive compared with culture and when used in conjunction with fluorescence microscopy resulted in higher efficiency.

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Mycological Examination

Atzori,

Pizzatti,

Pau

et al. 2023

European Handbook of Dermatological Treatments

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Comparison of direct microscopy, culture and calcofluor white for the diagnosis of onychomycosis

Cited by 29 publications

References 15 publications

Evaluation of a new fluorescent reagent, fluorescent brightener 85, for the diagnosis of suspected onychomycosis compared with potassium hydroxide

Evaluation of a new fluorescent reagent, fluorescent brightener 85, for the diagnosis of suspected onychomycosis compared with potassium hydroxide

Comparison of fungal fluorescent staining and ITS rDNA PCR‐based sequencing with conventional methods for the diagnosis of onychomycosis

Mycological Examination

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