Onychomycosis associated with Onychocola canadensis:: Ten case reports and a review of the literature

被引:49
|
作者
Gupta, AK
Horgan-Bell, CB
Summerbell, RC
机构
[1] Sunnybrook Hlth Sci Ctr, Dept Med, Div Dermatol, Toronto, ON M4N 3M5, Canada
[2] Univ Western Ontario, Dept Med, Div Dermatol, London, ON, Canada
[3] Univ Toronto, Dept Lab Med & Pathobiol, Toronto, ON, Canada
[4] Ontario Minist Hlth, Lab Serv Branch, Toronto, ON M5W 1R5, Canada
关键词
D O I
10.1016/S0190-9622(98)70316-0
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Background: Onychocola canadensis is a nondermatophyte mold associated with onychomycosis particularly in temperate climates (eg, Canada, New Zealand, and France). The slow growth rate of O canadensis and lack of resemblance to any other known nail-infecting fungus may have delayed its discovery. We are aware of 23 mycologically confirmed cases of O canadensis in the literature. Objective: We describe 10 previously unreported Canadian patients, specimens from whom grew O canadensis. We also review the literature on infections associated with this organism, Methods: Cases of O canadensis onychomycosis were diagnosed on the basis of (1) the finding of compatible filaments on direct microscopy of nail and (2) consistent culture from repeated specimens. Ail patients from whom O canadensis was isolated were followed up, but those in whom outgrowth was not consistent were not accepted as having "authentic" infections. Results: In 10 patients O canadensis was found to be associated with distal lateral subungual onychomycosis (6 patients), white superficial onychomycosis (1 patient), and as an insignificant contaminant in the nails of 3 patients. Less commonly the organism may cause tinea manuum or tinea pedis interdigitalis. O canadensis appears to be more frequent in the elderly, especially females. It is not unusual for a patient with onychomycosis caused by O canadensis to be a gardener or farmer, suggesting that the infectious inoculum may originate from the sail. The optimal therapy for onychomycosis caused by this organism remains unclear. Conclusion: O canadensis may be the etiologic agent of distal and lateral subungual or white superficial onychomycosis; however, it may sometimes be present in an abnormal-appearing nail as an insignificant finding, not acting as a pathogen.
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收藏
页码:410 / 417
页数:8
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