Green nail syndrome caused by Citrobacter braakii

Mulita, Francesk; Tchabashvili, Levan; Liolis, Elias; Tasios, Konstantinos; Iliopoulos, Fotios; Kaplanis, Charalampos; Parchas, Nikolaos; Plachouri, Kerasia‐Maria

doi:10.1002/ccr3.4203

Cited by 6 publications

(10 citation statements)

References 2 publications

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“…Green nail syndrome can be associated with either a singular bacterial infection, a singular fungal infection, or a polymicrobial infection [3][4][5][6][7][8][9][10][11][12]. Single bacterial etiologies for green nail syndrome are caused by gramnegative organisms.…”

Section: Discussionmentioning

confidence: 99%

“…Single bacterial etiologies for green nail syndrome are caused by gramnegative organisms. They include Citrobacter braakii, Pseudomonas aeruginosa, and Pseudomonas oryzihabitans (Table 1) [5][6][7].…”

Section: Discussionmentioning

confidence: 99%

“…Abbreviations: A, age (years); M, man; Ref, references; S, sex; W, woman a Initial treatment with amoxicillin/clavulanic acid was unsuccessful [5].…”

Section: Table 1: Single Bacterial Etiologies Of Green Nail Discolorationmentioning

confidence: 99%

“…However, it has been associated with chloronychia in a 34-year-old woman who presented with painful swelling around her right index fingernail one month after injury to this digit. Two weeks prior to her presentation, she noticed a green hue to her nail plate, which progressively worsened; she was empirically treated with amoxicillin/clavulanic acid which did not improve her symptoms [5].…”

Section: Table 1: Single Bacterial Etiologies Of Green Nail Discolorationmentioning

confidence: 99%

“…Bacterial culture after onychectomy and drainage of the abscess grew Citrobacter braakii. The patient was treated with ciprofloxacin; all symptoms had resolved, without recurrence, at the five-day follow-up [5].…”

Section: Table 1: Single Bacterial Etiologies Of Green Nail Discolorationmentioning

confidence: 99%

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Fungal Viridionychia: Onychomycosis-Induced Chloronychia Caused by Candida parapsilosis-Associated Green Nail Discoloration

Forouzan¹,

Cohen²

2021

Cureus

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Green nail syndrome is a form of chromonychia, discoloration of the nail plate, that describes fingernails or toenails that are green in appearance. Bacterial-associated green nail syndrome, referred to as chloronychia, is most common; however, fungal and polymicrobial etiologies have been reported. Two 70-year-old women presented with green discoloration of their nails for over five months; both women had prior unsuccessful treatments and were referred for further evaluation and treatment. The affected nails were biopsied and cultured. Bacterial cultures did not yield any organisms; however, fungal cultures grew Candida parapsilosis after four weeks. Both women were treated with a topical alcohol-based solution and ketoconazole cream with improvement in their nail discoloration after two months. We introduce a term that specifically describes fungal etiology-associated green nail syndrome: viridionychia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Abbreviations: A, age (years); M, man; Ref, references; S, sex; W, woman a Initial treatment with amoxicillin/clavulanic acid was unsuccessful [5].…”

Section: Table 1: Single Bacterial Etiologies Of Green Nail Discolorationmentioning

confidence: 99%

Section: Table 1: Single Bacterial Etiologies Of Green Nail Discolorationmentioning

confidence: 99%

Section: Table 1: Single Bacterial Etiologies Of Green Nail Discolorationmentioning

confidence: 99%

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Fungal Viridionychia: Onychomycosis-Induced Chloronychia Caused by Candida parapsilosis-Associated Green Nail Discoloration

Forouzan¹,

Cohen²

2021

Cureus

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A bacteriophage against Citrobacter braakii and its synergistic effect with antibiotics

Liu,

Li,

Zhu

et al. 2024

Arch Microbiol

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Green Nail Syndrome Treated with Ozenoxacin: Two Case Reports

Cosio,

Petruccelli,

Gaziano

et al. 2023

Case Rep Dermatol

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Green nail syndrome (GNS) is a persistent greenish pigmentation of the nail plate, originally described in 1944 by Goldman and Fox, due to Pseudomonas aeruginosa infection. Recently, pulmonary co-infection of P. aeruginosa and Achromobacter spp. has been described in patients with cystic fibrosis. Achromobacter xylosoxidans is a multidrug-resistant (MDR) pathogen involved in lung and soft tissue skin infections. Both Achromobacter xylosoxidans and P. aeruginosa are mainly found in humid environments or in water. There are no recognized co-infections due to P. aeruginosa and A. xylosoxidans in the skin and appendages. We describe two cases of GNS, the first due to P. aeruginosa associated with Achromobacter xylosoxidans; the other due to MDR P. aeruginosa, both successfully treated with topical ozenoxacin 1% cream daily for 12 weeks. The clinical management of GNS can be confusing, especially when the bacterial culture result is inconsistent or when non-Pseudomonas bacteria are isolated. In our case, due to the co-infection of P. aeruginosa and Achromobacter spp., local treatment with ozenoxacin – the first nonfluorinated quinolone – could be a safe and effective treatment in case of MDR nail infections. Further studies are required to evaluate clinical isolation from nail infections and the co-presence of P. aeruginosa and A. xylosoxidans.

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Green nail syndrome caused by Citrobacter braakii

Cited by 6 publications

References 2 publications

Fungal Viridionychia: Onychomycosis-Induced Chloronychia Caused by Candida parapsilosis-Associated Green Nail Discoloration

Fungal Viridionychia: Onychomycosis-Induced Chloronychia Caused by Candida parapsilosis-Associated Green Nail Discoloration

A bacteriophage against Citrobacter braakii and its synergistic effect with antibiotics

Green Nail Syndrome Treated with Ozenoxacin: Two Case Reports

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