Korean J Med Mycol.  2016 Dec;21(4):129-134. 10.17966/KJMM.2016.21.4.129.

A Case of Toenail Onychomycosis Due to Aspergillus terreus

• Yun SY
• Park MW
• Suh MK
• Ha GY

• KMID: 2369000
• DOI: http://doi.org/10.17966/KJMM.2016.21.4.129

Abstract

Onychomycosis is caused by dermatophytes usually, but some species of nondermatophytic molds and yeasts are also associated with invasion of nails. Aspergillus(A.) terreus is a nondermatophytic mold which is opportunistic filamentous fungus in all environments. We report a case of onychomycosis caused by A. terreus in a 60-year-old male. The patient showed brownish yellow discoloration with hyperkeratotic change on the distal and lateral portion of both toenails. Direct microscopic examination of scraping on the potassium hydroxide preparation revealed septate hyphae and repeated cultures on Sabouraud's dextrose agar showed the velvety, cinnamon brown colonies. Biseriate and compactly columnar phialides that cover upper vesicle with conidial structure were shown in the slide culture. The DNA sequence of internal transcribed spacer (ITS) region of clinical sample was 99% match to that of A. terreus strain ATCC 20542 (GenBank accession number GU256759.1). We confirmed A. terreus by KOH mount, colony, light microscopic morphology and DNA sequence analysis. The patient was treated with 200 mg oral itraconazole daily and topical 5% amorolfine nail lacquer for 3 months.

Keyword

Aspergillus terreus; Toenail onychomycosis

MeSH Terms

Agar
Arthrodermataceae
Aspergillus*
Base Sequence
Cinnamomum zeylanicum
Fungi
Glucose
Humans
Hyphae
Itraconazole
Lacquer
Male
Middle Aged
Nails*
Onychomycosis*
Potassium
Sequence Analysis, DNA
Yeasts
Agar
Glucose
Itraconazole
Potassium