Fingernail Onychomycosis Due toAspergillus niger

Abstract

Onychomycosis is usually caused by dermatophytes, but some species of nondermatophytic molds and yeasts are also associated with nail invasion. Aspergillus niger is a nondermatophytic mold which exists as an opportunistic filamentous fungus in all environments. Here, we report a case of onychomycosis caused by A. niger in a 66-year-old female. The patient presented with a black discoloration and a milky white base and onycholysis on the proximal portion of the right thumb nail. Direct microscopic examination of scrapings after potassium hydroxide (KOH) preparation revealed dichotomous septate hyphae. Repeated cultures on Sabouraud's dextrose agar (SDA) without cycloheximide produced the same black velvety colonies. No colony growth occurred on SDA with cycloheximide slants. Biseriate phialides covering the entire vesicle with radiate conidial heads were observed on the slide culture. The DNA sequence of the internal transcribed spacer region of the clinical sample was a 100% match to that of A. niger strain ATCC 16888 (GenBank accession number AY373852). A. niger was confirmed by KOH mount, colony identification, light microscopic morphology, and DNA sequence analysis. The patient was treated orally with 250 mg terbinafine daily and topical amorolfine 5% nail lacquer for 3 months. As a result, the patient was completely cured clinically and mycologically.

Onychomycosis due to Aspergillus niger without black nail discoloration: A case report

“…Black pigmentation may be observed in the nails due to conidia of Aspergillus niger [1]. It is a diagnostic clue for onychomycosis due to Aspergillus niger, however, we didn't observe any pigmentation in our patients toenail.…”

Subungual onychomycosis due to Aspergillus niger mimicking a glomus tumor: A case report

“…With regard to onychomycosis caused by Aspergillus niger, five cases have been reported. The five cases occurred in adults aged 39-66 years (2)(3)(4)(5). Four cases involved toe nails and one case involved fingernails.…”

“…However, Aspergillus niger is not common as a cause of nail onychomycosis. There are few reports on onychomycosis caused by Aspergillus niger (2)(3)(4)(5). On the other hand, the most common site of glomus tumor is distal phalanx of the fingers, especially in the subungual region (6,7).…”

“…Onychomycosis cases caused by Aspergillus spp. are reported to be 2.6-6.1% (2). However, Aspergillus niger is not common as a cause of nail onychomycosis.…”

Comparative Study of Terbinafine Hydrochloride Transfersome, Menthosome and Ethosome Nanovesicle Formulations via Skin Permeation and Antifungal Efficacy

“…(Moreno and Arenas, 2010). Aspergillus niger, an opportunistic filamentous fungus, is found to be associated with nail onychomycosis in both toenails and fingernail lesions (Kim et al, 2012). Terbinafine showed higher cure rates, when administered to treat onychomycosis, especially those caused by Aspergillus niger (Gianni and Romano, 2004).…”