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   Abstract
   Introduction
   Case Report
   Discussion
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CASE REPORTS
Year : 2000  |  Volume : 66  |  Issue : 2  |  Page : 93-94

Onychomycosis caused by trichosporon beigelii




Correspondence Address:
D Vijaya


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Source of Support: None, Conflict of Interest: None


PMID: 20877039

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  Abstract 

Onychomycosis is caused primarily by dermatophytes, candida sp and nondermatophytic moulds. Trichosporon beigelii is an inhabitant of soil and occasionally is part of the normal flora of human skin. A 38- year- old male presented with brown discolouration of both big toes since one year. Repeated KOH preparation and culture of nail scrapings and clippings yielded Trichosporon beigelii, which was identified by standard techniques.


Keywords: Onychomycosis, Trichosporon beigelii


How to cite this article:
Vijaya D, Anand BK, Nagarathamma T, Joseph M. Onychomycosis caused by trichosporon beigelii. Indian J Dermatol Venereol Leprol 2000;66:93-4

How to cite this URL:
Vijaya D, Anand BK, Nagarathamma T, Joseph M. Onychomycosis caused by trichosporon beigelii. Indian J Dermatol Venereol Leprol [serial online] 2000 [cited 2019 Sep 17];66:93-4. Available from: http://www.ijdvl.com/text.asp?2000/66/2/93/4881



  Introduction Top


Onychomycosis is one of the most common nail disorder seen by Dermatologists. It impairs nail functions, causes considerable pain, interferes with daily activities and has negative psychological effect. [1] Onychomycosis has an overall prevalence of 2% to 13%, but the prevalence is much higher in certain populations, as older people and those with immuosuppressive conditions. [2]

Onychomycosis may be caused by non dermatophytic filamentous fungi and yeast- like fungi, particularly after damage to tissue by a trauma or disease like dystrophic nails. [3] We describe a well documented case of onychomycosis caused by Trichosporon beigelii, isolated from both big toe nails of the same patient and repeated isolation of the same fungi.


  Case Report Top


A 38-year-old man presented with progressive brown discolouration of both big toes since one year. He was a clerk, living with normal hygiene. He wore leather shoes and nylon socks and did not go out bare foot normally. There was no history of any trauma to the toes.

Examination revealed onycholysis and hyperkeratosis of the internal plate and uniform brown colouring affecting both big toe nails. Routine investigations were within normal limit. Nail scrapings and clippings were incu­bated in 40% KOH for 30 minutes for direct examination. KOH prepa­ration showed abundant hyphae and spores. The samples were subsequently I cultured on 2 sets of j Sabourauds Dextrose Agar (SDA) with chloromycetin, and cyclohexamide and dermatophyte test medium. One set was incubated at 37°C and other set at room temperature. After 72 hours white creamy hairy colony had grown on SDA with chloromycetin incubated at 37°C and room

temperature. No growth was present on SDA with actidione or on DTM. The isolate was identified as Trichosporon beigelii by standard techniques and confirmed by Microbiology Department, CMCH, Vellore, India.

The patient was treated with pulse therapy of itraconazole 200 mg bd for one week in a month, to which he responded well.


  Discussion Top


Lee et al reported, Trichosporon beigelii causing skin and toe nail infection. Heikkila reported that onychomycosis was not found below 20 years, but Loveland study showed that onychomycosis is a common paediatric condition. [4],[5] References are lacking on onychomycosis caused by Trichosporon beigelii & In the present case, the patient was an adult healthy man with no history of trauma or diabetes. Predisposing factors in this particular case may be the use of nylon socks and shoes throughout the day and the prevalent climatic condition could have played a role in causing this infection. Direct microscopy and culture when repeated confirmed the etiological agent as T.beigelii The confirmation of saprophytic moulds as the agents responsible for infection of nails is difficult because it is indispensable to discard a contamination. [6]

We stress on obtaining proper collection of samples, using appropriate tests and culture media, and accurately interpreting test results. These processes are of paramount importance for correct identification of this invading organism and in trun for effective prescribing.







 
  References Top

1.Drake LA, Scher RK, Smith KB, et al. Effect of onychomycosis on quality of life. 3 Am Acad Dermatol 1998 ; 38 : 7 - 2 - 4.  Back to cited text no. 1    
2.Lavy LA. Epidemiology of onychomycosis special risk populations (Review). J A Paed Med Assoc 1997 : 87 : 546 - 550.  Back to cited text no. 2    
3.Jagadish Chander. Other opportunistic fungal infections. A text­book of Medical Mycology. Interprint India 1996; 163-165.  Back to cited text no. 3    
4.Heikkila H, Stubb S. The prevalence of onychomycosis in Finland. Br 3 Dermatol 1995 ; 699 - 703.  Back to cited text no. 4    
5.Love land L J. Onychomycosis in HIV positive patients. Clinics in Paediatrc Medicine and Surgery. 1998 ; 15 : 305 - 315.  Back to cited text no. 5    
6.Torres Rodrignez JM, Balaguer Meler, Martinez AT et al. onychomycosis due to a fungus of the aspergillus versicolor group. Mycoses 1983 ; 31 579 - 583.  Back to cited text no. 6    


Figures

[Figure - 1], [Figure - 2], [Figure - 3]



 

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