Korean J Med Mycol.  2015 Mar;20(1):6-12. 10.17966/KJMM.2015.20.1.6.

A Case of Toenail Onychomycosis Due to Aspergillus sydowii Infection

Affiliations
  • 1Department of Dermatology, College of Medicine, Dongguk University, Gyeongju, Korea. smg@dongguk.ac.kr
  • 2Department of Laboratory Medicine, College of Medicine, Dongguk University, Gyeongju, Korea.
  • 3Department of Dermatology, College of Medicine, Yeungnam University, Daegu, Korea.

Abstract

Onychomycosis is caused by dermatophytes usually, but some species of nondermatophytic molds and yeasts are also associated with invasion of nails. Aspergillus sydowii is a nondermatophytic mold which is opportunistic filamentous fungus in all environments. We report a case of onychomycosis caused by A. sydowii in a 65-year-old male. The patient showed yellowish discoloration with hyperkeratotic change on the distal and lateral portion of both great toenails. Direct microscopic examination of scraping on the potassium hydroxide preparation revealed dichotomous septate hyphae and repeated cultures on Sabouraud dextrose agar showed the same blue green velvety colonies. Biseriate phialides that cover entire vesicle with conidial structure resembling Penicillium were shown in the slide culture. The DNA sequence of internal transcribed spacer (ITS) region of clinical sample was 99% match to that of A. sydowii strain XWSFJJ1 (GenBank accession number FJ461692). We confirmed A. sydowii by KOH mount, colony, light microscopic morphology and DNA sequence analysis. The patient was treated with 250 mg oral terbinafine daily and topical 5% amorolfine nail lacquer for 3 months.

Keyword

Aspergillus sydowii; Toenail onychomycosis

MeSH Terms

Agar
Aged
Arthrodermataceae
Aspergillus*
Base Sequence
Fungi
Glucose
Humans
Hyphae
Lacquer
Male
Nails*
Onychomycosis*
Penicillium
Potassium
Sequence Analysis, DNA
Yeasts
Agar
Glucose
Potassium
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