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Onychomycosis Caused by Fusarium Species

Eduardo Vinicius Grego Uemura1, Marcelo Dos Santos Barbosa1,2, Simone Simionatto1

  • 1Faculdade de Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados 79862-000, MS, Brazil.

Journal of Fungi (Basel, Switzerland)
|April 21, 2022
PubMed

Insights

Onychomycosis, a fungal nail infection, is increasingly caused by Fusarium species. This review analyzes 24 years of cases, identifying Fusarium solani as the most common culprit and highlighting geographic and demographic trends.

Area of Science:

  • Mycology
  • Dermatology
  • Infectious Diseases

Background:

  • Onychomycosis is a common nail fungal infection characterized by discoloration, thickening, and nail bed separation.
  • Species within the Fusarium genus are emerging as significant causes of onychomycosis, with increasing case numbers reported globally.
  • Accurate diagnosis relies on microscopic examination and fungal cultures.

Purpose of the Study:

  • To provide a comprehensive overview of onychomycosis cases attributed to Fusarium species reported in the literature over a 24-year period (January 1997 to January 2021).
  • To analyze demographic data, identify prevalent Fusarium species, and map geographic distribution of these infections.
  • To review the clinical presentation and discuss the importance of accurate etiological identification for effective treatment strategies.

Main Methods:

  • Systematic literature review of onychomycosis cases caused by Fusarium species.
  • Data extraction included patient demographics, identified Fusarium species, geographic location, and clinical presentation.
  • Analysis of reported cases from January 1997 to January 2021.

Main Results:

  • Patients aged 40-49 years represented 30.23% of cases.
  • Fusarium solani species complex (FSSC) was the most frequent cause (44.11%), followed by F. fujikuroi (17.64%), F. dimerum (14.70%), and F. oxysporum (14.70%).
  • Geographic distribution showed Europe accounting for 29.06% of FOSC cases and Africa for 46.67% of FSSC cases. The distal-lateral subungual pattern was the most common clinical presentation.

Conclusions:

  • Fusarium species, particularly FSSC, are increasingly implicated in onychomycosis, with distinct geographic and demographic patterns.
  • Accurate identification of the causative Fusarium species is critical for guiding appropriate antifungal therapy.
  • While limited, antifungal susceptibility testing data suggests its potential utility in managing Fusarium onychomycosis.
Keywords:
Fusariumclinical featuresepidemiologymycologyonychomycosis

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