Publication:

A clinicomycological study of onychomycosis in a rural hospital in Central India

Background Onychomycosis; fungal infection of nails account for about half of the nail diseases. Common site of involvement is toenails. Various etiological agents including dermatophytes, yeasts and non-dermatophytic moulds (NDM) are responsible. It is difficult to treat onychomycosis as compare to other dermatophytic infections because of the inherent slow growth of the nail.

Aim To diagnose etiological agents of onychomycosis on KOH, Calcofluor white (CFW), KOH treated Nail Clipping with Periodic Acid Schiff (KONCPA) and SDA culture.

Objectives 1) To determine the fungal etiological agents of onychomycosis. 1) To correlate clinical parameters with the mycological findings.

Methods The study was carried out in department of Microbiology, MGIMS, Sewagram, Wardha. A total of 44 cases with signs of onychomycosis were enrolled in the study which were subjected for microscopic examination by 20% KOH, CFW and KONCPA. Mycological culture was done on Sabouraud’s dextrose agar (with and without antibiotics).

Results On analysis, the positivity by 20% KOH andCFW was 45.5%, 63.4% respectively while by KONCPA it was found to be 25%. In 38.6% fungal cultures revealed growth. At present, the etiological agents were dermatophytes (12.5%), especially Trichophyton rubrum, nondermatophytic isolates (75%) include Aspergillus spp., Penicillium species, Rhizopus and Candida spp. (8.3%). In our study toenails were affected in 84% and distolateral subungual onychomycosis (DLSO) was the commonest clinical presentation.

Conclusion Along with dermatophytes, NDM and yeasts are also important etiological agents of onychomycosis in our set up.