Bacterial infection in a patient with onychomycosis☆,☆☆
Section snippets
CASE REPORT
A 58-year-old man with chronic dystrophic toenails had been treated with itraconazole, 400 mg daily for 1 week a month for three consecutive months, without improvement. The diagnosis of onychomycosis was made by the presence of septate hyphae on potassium hydroxide preparation without a fungal culture. Our examination then revealed that both first toenails had onycholysis, subungual debris, and black-green discoloration (Fig. 1). A bacterial
DISCUSSION
Onychomycosis is caused by dermatophyte fungi, Candida, and some nondermatophyte molds. 1 However, in some patients, a secondary bacterial infection can be present, as in our patient. Bacterial infection can also complicate interdigital tinea pedis, a condition referred to as “dermatophytosis complex.” 2,3 A bacterial and fungal culture may thus be necessary to identify all nail and foot pathogens. A clue that a patient has a significant bacterial infection is green discoloration of the nail,
References (4)
Progression of interdigital infections from simplex to complex
J Am Acad Dermatol
(1993)- et al.
A U.S. epidemiologic survey of superficial fungal diseases
J Am Acad Dermatol
(1996)
Cited by (20)
Subungual neuroma masquerading as green nail syndrome
2022, JAAD Case ReportsCitation Excerpt :In a study by Ohn et al7 in 2020, 65% of patients with green nail syndrome had fungal coinfection. In such cases, an extended course of antibiotics and antifungals has been used.10 In cases of persistent green nail syndrome, a full spectrum of potential underlying causes of onycholysis should be considered.
Green Nail Caused by Onychomycosis Coinfected With Pseudomonas aeruginosa
2019, Actas Dermo-SifiliograficasClinical Clues to Differentiate between Dermatophyte Onychomycosis (DP-OM) and Dermatophytoma-Like Traumatic Onychodystrophy (DP-TO)
2022, BioMed Research InternationalHistopathology of the nail: Onychopathology
2017, Histopathology of the Nail: OnychopathologyImproving cure rates in onychomycosis
2016, Journal of Cutaneous Medicine and Surgery
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Reprint requests: Boni E. Elewski, MD, Medical Director, Center for Medical Mycology, University Hospitals of Cleveland, 11100 Euclid Ave., Cleveland, OH 44106.
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