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Fingernail Onychomycosis Due to Aspergillus niger

Dong Min Kim1, Moo Kyu Suh, Gyoung Yim Ha

  • 1Department of Dermatology, College of Medicine, Dongguk University, Gyeongju, Korea.

Annals of Dermatology
|December 1, 2012
PubMed

Insights

Onychomycosis, a nail infection, can be caused by nondermatophytic molds like Aspergillus niger. This case study details a successful treatment of Aspergillus niger onychomycosis using oral terbinafine and topical amorolfine.

Area of Science:

  • Mycology
  • Dermatology
  • Clinical Microbiology

Background:

  • Onychomycosis is a common nail fungal infection, typically caused by dermatophytes.
  • Nondermatophytic molds and yeasts, including Aspergillus species, are increasingly recognized as causative agents.
  • Aspergillus niger is an opportunistic filamentous fungus found ubiquitously in the environment.

Observation:

  • A 66-year-old female presented with clinical signs of onychomycosis on her right thumb, including black discoloration, milky white base, and onycholysis.
  • Microscopic examination revealed dichotomous septate hyphae in potassium hydroxide (KOH) preparations.
  • Fungal cultures yielded characteristic black velvety colonies of Aspergillus niger, confirmed by slide culture morphology and DNA sequencing.

Findings:

  • Aspergillus niger was definitively identified as the causative agent of onychomycosis through a combination of KOH mount, culture, morphology, and DNA sequencing.
  • The internal transcribed spacer (ITS) region DNA sequence of the clinical isolate showed a 100% match with Aspergillus niger ATCC 16888.
  • The patient received a 3-month treatment regimen comprising oral terbinafine and topical amorolfine 5% nail lacquer.

Implications:

  • This case highlights Aspergillus niger as a potential pathogen in onychomycosis, emphasizing the importance of accurate mycological diagnosis.
  • Successful treatment outcomes demonstrate the efficacy of combined oral and topical antifungal therapy for Aspergillus niger onychomycosis.
  • Further research into nondermatophytic mold onychomycosis is warranted to understand prevalence and optimize management strategies.
Keywords:
Aspergilus nigerFingernailsOnychomycoses

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