Onychomycosis caused byAspergillus versicolor

Abstract

We report a case of onychomycosis caused by Aspergillus versicolor in a 66-year-old female patient. The infection was characterised clinically by yellowish pigmentation of the nail plate and mild nail bed hyperkeratosis of the first left toe. All other nails were normal. Three direct microscopical examinations of nail samples revealed the presence of hyaline hyphae as well as conidiophores. Pure colonies of A. versicolor were found in three cultures. The patient was successfully treated with oral itraconazole. Case reportA 66-year-old female patient was admitted to our institute because of a yellowish pigmentation of the nail plate of the first left toe. The patient stated that she was in good general health, that she was not under treatment with systemic drugs and that the pigmentation appeared 6 months earlier.General physical examination did not reveal any pathological symptoms. Dermatological examination showed a yellowish pigmentation involving the distal portion of the nail plate of the first left toe (Fig. 1). Mild nail bed hyperkeratosis was also observed. All other nails were normal.Laboratory examinations included complete blood count, protein electrophoresis, metabolic tests (glucose, cholesterol, triglycerides and uric acid), renal tests (urea, creatinine and electrolytes), hepatic tests (bilirubin, transaminases, gamma-glutamyltransferase, alkaline phosphatase, cholinesterase, lacticodehydrogenase), inflammatory tests (erythro-sedimentation rate) and urinalysis and all examinations were normal.Bacteriological examinations were negative. A clinical diagnosis of onychomycosis was made. Three direct microscopical examinations of samples obtained from different areas of the affected nail collected on the same day were performed. They revealed the presence of intact and fragmented hyphae: the latter were intertwined and hyaline; very long, thin and smooth conidiophores were also observed (Fig. 2). Pure colonies of Aspergillus versicolor were found in three different cultures (Petri plates with Sabouraud dextrose agar with chloramphenicol, added with cycloheximide) (Fig. 3).Oral itraconazole pulse therapy was given to the patient (200 mg twice daily for 1 week, with 3 weeks off between successive pulses, for four pulses). Itraconazole was chosen because of previous history of urticaria and angio-oedema caused by terbinafine; the latter was used at another dermatological centre because of tinea corporis (Fig. 4). At the end of the therapy, mycological examinations were negative. A 2-year follow-up was negative both clinically and mycologically. Figure 1 Yellowish pigmentation of the distal portion of the nail plate of the first left toe.

Antifungal and Antioxidant Activities of the Essential Oil from Angelica koreana Nakai

“…Among the Aspergillus species, A. fumigatus is the most common human infectious agent, followed by A. flavus, A. niger, and A. terreus [11–13]. A. versicolor produces many toxic compounds, which can cause severe symptoms in humans and animals infected through inhalation or other forms of contact with debris or spores [14, 15]. …”

Aspergillus versicolor, a New Causative Agent of Canine Disseminated Aspergillosis

“…Others, such as A. terreus (subgenus Terrei, section Terrei) and A. versicolor (subgenus Nidulantes, section Nidulantes), are occasionally isolated from clinical specimens (3,29). The disease conditions, ranging from localized skin infection, nail infection, ocular infection, and pulmonary disorder to invasive systemic Aspergillus infection causing diskospondylitis, osteomyelitis, and pyelonephritis, are collectively referred to as "aspergillosis," an umbrella term coined by Hinson, Moon, and Plummer in 1952 (7,30,31,38,42).…”

Monitoring of Microscopic Filamentous Fungi in Indoor Air of Transplant Unit

“…Aspergillus sydowii and Aspergillus versicolor have been established in the input filter. Literature describes cases of onychomycosis or peritonitis in connection with peritoneal dialysis (17)(18)(19). These findings could be related to the clogs of all the staff, which are removed here.…”