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Fusarium fingernail infection responsive to fluconazole intermittent therapy
S S Tseng1, B J Longley, R K Scher
1Department of Dermatology, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
Abstract:
A case of fingernail infection by Fusarium is presented. This nondermatophytic mold is an infrequent cause of onychomycosis, more typically involving the great toenail. Characteristic histologic features including the presence of hyphae and chlamydoconia are helpful in rapid diagnosis and selection of appropriate antifungal therapy. Although Fusarium has shown resistance to most antifungal medications in vitro, intermittent therapy with fluconazole led to improvement in this patient.
Insights
Fingernail infections by Fusarium, a mold rarely causing onychomycosis, can be diagnosed by identifying hyphae and chlamydoconia. Intermittent fluconazole therapy showed improvement despite in vitro resistance.
Area of Science:
- Medical Mycology
- Dermatology
- Infectious Diseases
Background:
- Onychomycosis, a fungal nail infection, is commonly caused by dermatophytes.
- Fusarium species are infrequently implicated in onychomycosis, typically affecting toenails.
Observation:
- A case of fingernail infection caused by Fusarium is described.
- Histologic examination revealed characteristic fungal elements: hyphae and chlamydoconia.
Findings:
- Fusarium species demonstrate in vitro resistance to many antifungal agents.
- The patient experienced clinical improvement with intermittent fluconazole therapy.
Implications:
- Histological features aid in the rapid diagnosis of Fusarium onychomycosis.
- Intermittent fluconazole may be a viable therapeutic option for this rare infection.