Ann Dermatol.  2012 Nov;24(4):459-463. 10.5021/ad.2012.24.4.459.

Fingernail Onychomycosis Due to Aspergillus niger

• Kim DM
• Suh MK
• Ha GY
• Sohng SH

• KMID: 2266043
• DOI: http://doi.org/10.5021/ad.2012.24.4.459

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.

Keyword

Aspergilus niger; Fingernails; Onychomycoses

MeSH Terms

Agar
Aged
Arthrodermataceae
Aspergillus
Aspergillus niger
Base Sequence
Cycloheximide
Female
Fungi
Glucose
Head
Humans
Hydroxides
Hyphae
Lacquer
Light
Morpholines
Nails
Naphthalenes
Niger
Onycholysis
Onychomycosis
Potassium
Potassium Compounds
Sequence Analysis, DNA
Sprains and Strains
Thumb
Yeasts
Agar
Cycloheximide
Glucose
Hydroxides
Morpholines
Naphthalenes
Potassium
Potassium Compounds

Figure

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  Fig. 1 Black discoloration with milky white base and onycholysis on the proximal portion of the right thumb nail.

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  Fig. 2 Direct microscopic examination of scraping from a potassium hydroxide (KOH) preparation revealing dichotomous septate hyphae (KOH mount, ×400).

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  Fig. 3 Multiple, black colonies with velvety surfaces on Sabouraud's dextrose agar slants after 1 week at 25℃.

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  Fig. 4 A rapidly growing, black colony with a velvety surface on an Sabouraud's dextrose agar plate after 5 days at 25℃.

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  Fig. 5 Biseriate phialides covering the entire vesicle with radiate conidial heads in a slide culture of Aspergillus niger (lactophenol-cotton blue stain, ×400).

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  Fig. 6 Alignment of internal transcribed spacer (ITS) sequences showing the ITS sequence from the clinical sample was a 100% match to that of Aspergillus niger strain ATCC 16888 (GenBank accession number AY373852).

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