Skip to main content

Advertisement

Log in

Onychomycoses in a Military Population in Brazil

  • Clinical Mycology Lab Issues (S Córdoba, Section Editor)
  • Published:
Current Fungal Infection Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This study aimed to isolate and characterize filamentous fungi onychomycosis agents in a military population assisted at a hospital outpatient clinic.

Recent Findings

In onychomycosis, the fungi colonize the subungual region causing thickening, discoloration, or cracking of the nail bed. Samples were collected from patients with clinical sights of onychomycosis.

Summary

Among 80 samples collected, 50 (62.5%) had positive culture. Isolated dermatophytes (86%) were Trichophyton rubrum (21; 42%), T. mentagrophytes var. interdigitale (19; 38%), and Microsporum gypseum (3; 6%) and non-dermatophyte molds were Fusarium spp. (1; 2%), Scytalidium spp. (1; 2%), and Chaetomium globosum (5; 10%). Minimal inhibitory concentrations (mg/L) of terbinafine, itraconazole, and fluconazole necessary to inhibit 50/90% of the isolates were respectively 0.015/0.06, 0.06/0.12, and 32/32. Etiological agents of onychomycosis in a military hospital are similar as reported in studies for the general population. High prevalence of non-dermatophytic agents was observed, especially for Chaetomium globosum.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ghannoum MA, Hajjeh RA, Scher R, Konnikov N, Gupta AK, Summerbell R, et al. A large-scale North American study of fungal isolates from nails: the frequency of onychomycosis, fungal distribution, and antifungal susceptibility patterns. J Am Acad Dermatol. 2000;43:641–8.

    Article  CAS  PubMed  Google Scholar 

  2. Mahoney JM, Bennet J, Olsen B. The diagnosis of onychomycosis. Dermatol Clin. 2003;21:463–7.

    Article  PubMed  Google Scholar 

  3. Elewski BE. Onychomycosis: pathogenesis, diagnosis, and management. Clin Microbiol Rev. 1998;11(3):415–29.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Katoh T. Guidelines for diagnosis and treatment of mucocutaneous candidiasis. Jpn J Med Mycol. 2009;50:207–12.

    Article  Google Scholar 

  5. Iorizzo M, Piraccini BM, Rech G, Tosti A. Treatment of onychomycosis with oral antifungal agents. Expert Opin Drug Deliv. 2005;2:435–40.

    Article  PubMed  Google Scholar 

  6. Stüttgen G, Bauer E. Bioavailability, skin- and nailpenetration of topically applied antimycotics. Mycoses. 1982;25:74–80.

    Article  Google Scholar 

  7. Santos DA, Barros MES, Hamdan JS. Establishing a method of inoculum preparation for susceptibility testing of Trichophyton rubrum and Trichophyton mentagrophytes. J Clin Microbiol. 2006;44:98–101.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Silva Barros ME, de Assis SD, Hamdan JS. Evaluation of susceptibility of Trichophyton mentagrophytes and Trichophyton rubrum clinical isolates to antifungal drugs using a modified CLSI microdilution method (M38-A). J Med Microbiol. 2007;56:514–8.

    Article  PubMed  Google Scholar 

  9. Ameen M, Lear JT, Madan V, Mohd Mustapa MF, Richardson M. British Association of Dermatologists’ guidelines for the management of onychomycosis. Br J Dermatol. 2014;171:937–58.

    Article  CAS  PubMed  Google Scholar 

  10. Roberts DT. Prevalence of dermatophyte onychomycosis in the United Kingdom: results of an omnibus survey. Br J Dermatol. 1992;126:23–7.

    Article  PubMed  Google Scholar 

  11. Aly R. Ecology and epidemiology of dermatophyte infections. J Am Acad Dermatol. 1994;31:21–5.

    Article  Google Scholar 

  12. Scher RK, Baran R. Onychomycosis in clinical practice: factors contributing to recurrence. Br J Dermatol. 2003;149:5–9.

    Article  PubMed  Google Scholar 

  13. Segal R, Shemer A, Hochberg M, et al. Onychomycosis in Israel: epidemiological aspects. Mycoses. 2015;58:133–9.

    Article  CAS  PubMed  Google Scholar 

  14. Drakensjö IT, Chryssanthou E. Epidemiology of dermatophyte infections in Stockholm, Sweden: a retrospective study from 2005–2009. Med Mycol. 2011;49:484–8.

    PubMed  Google Scholar 

  15. Saunte D, Svejgaard E, Haedersdal M, Frimodt-Møller N, Jensen AM, Arendrup CM. Laboratory-based survey of dermatophyte infections in Denmark over a 10-year period. Acta Derm Venereol. 2008;88:614–6.

    PubMed  Google Scholar 

  16. Tchernev G, Penev PK, Nenoff P, et al. Onychomycosis: modern diagnostic and treatment approaches. Wien Med Wochenschr. 2013;163:1–12.

    Article  PubMed  Google Scholar 

  17. Dolenc-Voljc M. Dermatophyte infections in the Ljubljana region, Slovenia, 1995–2002. Mycoses. 2005;48:181–6.

    Article  PubMed  Google Scholar 

  18. Garg A, Venkatesh V, Singh M, Pathak KP, Kaushal GP, Agrawal SK. Onychomycosis in central India: a clinicoetiologic correlation. Int J Dermatol. 2004;43:498–502.

    Article  PubMed  Google Scholar 

  19. Nzenze Afene S, Ngoungou EB, Mabika Mamfoumbi M, Bouyou Akotet MK, Avome Mba IM, Kombila M. Les onychomycoses au Gabon: aspects cliniques et mycologiques. J Mycol Med. 2011;21:248–55.

    Article  Google Scholar 

  20. Summerbell RC, Cooper E, Bunn U, Jamieson F, Gupta AK. Onychomycosis: a critical study of techniques and criteria for confirming the etiologic significance of nondermatophytes. Med Mycol. 2005;43:39–59.

    Article  PubMed  Google Scholar 

  21. Gupta AK, Cooper EA, MacDonald P, Summerbell RC. Utility of inoculum counting (Walshe and English criteria) in clinical diagnosis of onychomycosis caused by nondermatophytic filamentous fungi. J Clin Microbiol. 2001;39:2115–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Kemna ASCP, Elewski BE. A U.S. epidemiologic survey of superficial fungal diseases. J Am Acad Dermatol. 1996;35:539–42.

    Article  CAS  PubMed  Google Scholar 

  23. Koussidou T, Devliotou-Panagiotidou D, Karakatsanis G, et al. Onychomycosis in Northern Greece during 1994–1998. Mycoses. 2002;45:29–37.

    Article  CAS  PubMed  Google Scholar 

  24. Gianni C, Cerri A, Crosti C. Non-dermatophytic onychomycosis. An underestimated entity? A study of 51 cases. Mycoses. 2000;43:29–33.

    Article  CAS  PubMed  Google Scholar 

  25. Tosti A, Piraccini BM, Lorenzi S. Onychomycosis caused by nondermatophytic molds: clinical features and response to treatment of 59 cases. J Am Acad Dermatol. 2000;42:217–24.

    Article  CAS  PubMed  Google Scholar 

  26. Heikkila H, Stubb S. The prevalence of onychomycosis in Finland. Br J Dermatol. 1995;133:699–703.

    Article  CAS  PubMed  Google Scholar 

  27. Clayton YM. Clinical and mycological diagnostic aspects of onychomycoses and dermatomycoses. Clin Exp Dermatol. 1992;17:37–40.

    Article  PubMed  Google Scholar 

  28. Maraki S, Nioti E, Mantadakis E, Tselentis Y. A 7-year survey of dermatophytoses in Crete, Greece. Mycoses. 2007;50:481–4.

    Article  PubMed  Google Scholar 

  29. El Sayed F, Ammoury A, Haybe RF, Dhaybi R. Onychomycosis in Lebanon: a mycological survey of 772 patients. Mycoses. 2006;49:216–9.

    Article  PubMed  Google Scholar 

  30. Gupta AK, Jain HC, Lynde CW, Watteel GN, Summerbell RC. Prevalence and epidemiology of unsuspected onychomycosis in patients visiting dermatologists’ offices in Ontario, Canada—a multicenter survey of 2001 patients. Int J Dermatol. 1997;6:783–7.

    Article  Google Scholar 

  31. Araújo AJG, Souza MAJ, Bastos OM, Oliveira JC. Onychomycosis caused by emergent fungi: clinical analysis, diagnosis and revision. An Bras Dermatol. 2003;78:445–55.

    Article  Google Scholar 

  32. Brilhante RSN, Paixão GC, Salvino LK, Diógenes MJN, Bandeira SP, Rocha MFG, et al. Epidemiologia e ecologia das dermatofitoses na cidade de Fortaleza: o Trichophyton tonsurans como importante patógeno emergente da Tinea capitis. Rev Soc Bras Med Trop. 2000;33:417–25.

    Article  CAS  PubMed  Google Scholar 

  33. Costa M, Passos XS, Souza LKH, Miranda ATB, Lemos JÁ, Júnior JGO, et al. Epidemiologia e etiologia das dermatofitoses em Goiânia, GO, Brasil. Rev Soc Bras Med Trop. 2002;35:19–22.

    Article  PubMed  Google Scholar 

  34. Lacaz CS, Porto E, Melo NT. Guia para identificação: fungos, actimomicetos e algas de interesse medico. 1a edição. São Paulo: Savier; 1998.

    Google Scholar 

  35. Bassiri-Jahromi S, Khaksar AA. Nondermatophytic moulds as a causative agent of onychomycosis in Tehran. Indian J Dermatol. 2010;55:140–3.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Hilmioğlu-Polat S, Metin DY, Inci R, Dereli T, Kilinç I, Tümbay E. Non-dermatophytic molds as agents of onychomycosis in Izmir, Turkey—a prospective study. Mycopathologia. 2005;160:125–8.

    Article  PubMed  Google Scholar 

  37. Ramani R, Srinivas CR, Ramani A, Kumari TG, Shivananda PG. Molds in onychomycosis. Int J Dermatol. 1993;32:877–8.

    Article  CAS  PubMed  Google Scholar 

  38. Stiller MJ, Rosenthal S, Summerbell RC, et al. Onychomycosis of the toenails caused by Chaetomium globosum. J Am Acad Dermatol. 1992;26:775–6.

    Article  CAS  PubMed  Google Scholar 

  39. Rippon JW. Medical mycology: the pathogenic fungi and the pathogenic actinomycetes, 3rd ed. Philadelphia: W.B. Saunders Co.; 1988.

    Google Scholar 

  40. Hattori N, Adachi M, Kaneko T, Shimozuma M, Ichinohe M, Iozumi K. Case report. Onychomycosis due to Chaetomium globosum successfully treated with itraconazole. Mycoses. 2000;43:89–92.

    Article  CAS  PubMed  Google Scholar 

  41. Naidu J, Singh SM, Pouranik M. Onychomycosis caused by Chaetomium globosum Kunze. Mycopathologia. 1991;113:31–4.

    Article  CAS  PubMed  Google Scholar 

  42. Fernández-Torres B, Carrillo AJ, Martín E, Del Palacio A, Moore MK, Valverde A, et al. In vitro activities of 10 antifungal drugs against 508 dermatophyte strains. Antimicrob Agents Chemother. 2001;45:2524–8.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Mukherjee PK, Leidich SD, Isham N, Leitner I, Ryder NS, Ghannoum MA. Clinical Trichophyton rubrum strain exhibiting primary resistance to terbinafine. Antimicrob Agents Chemother. 2003;47:82–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Tamura T, Asahara M, Yamamoto M, Yamaura M, Matsumura M, Goto K, et al. In vitro susceptibility of dermatomycoses agents to six antifungal drugs and evalution by fractional inhibitory concentration index of combined effects of amorolfine and itraconazole in dematophytes. Microbiol Immunol. 2014;58:1–8.

    Article  CAS  PubMed  Google Scholar 

  45. Carrillo-Muñoz AJ, Guglietta A, Palacín C, Casals J, del Valle O, Guardià C, et al. In vitro antifungal activity of sertaconazole compared with nine other drugs against 250 clinical isolates of dermatophytes and Scopulariopsis brevicaulis. Chemotherapy. 2004;50:308–13.

    Article  PubMed  Google Scholar 

  46. Yamazaki H, Nakamoto M, Shimizu M, Murayama N, Niwa T. Potential impact of cytochrome P450 3A5 in human liver on drug interactions with triazoles. Br J Clin Pharmacol. 2010;69:593–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Jessup CJ, Ryder NS, Ghannoum MA. An evaluation of the in vitro activity of terbinafine. Med Mycol. 2000;38:155–9.

    Article  CAS  PubMed  Google Scholar 

  48. Osborne CS, Hofbauer B, Favre B, Ryder NS. In vitro analysis of the ability of Trichophyton rubrum to become resistant to terbinafine. Antimicrob Agents Chemother. 2003;47:3634–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Marcia de Souza Carvalho Melhem.

Ethics declarations

Conflict of Interest

The authors declare that they have no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Clinical Mycology Lab Issues

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bentine, L.L.M., Bonfietti, L.X., Szeszs, M.W. et al. Onychomycoses in a Military Population in Brazil. Curr Fungal Infect Rep 11, 171–175 (2017). https://doi.org/10.1007/s12281-017-0291-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12281-017-0291-8

Keywords

Navigation