Fungal infections in the Netherlands. Prevailing fungi and pattern of infection

Species of fungi have specific characteristics in geographic distribution, and they have a predilection for certain body areas.

To obtain information about the prevailing fungi and their pattern of infection in the Netherlands.

An analysis was made of the results of mycological examinations carried out in subjects referred to the mycological laboratory of the Department of Dermatology, University Hospital Leiden, the Netherlands, in the period of 1972-1992.

The feet, extremities and groin were most commonly infected. The feet and extremities were mainly infected with dermatophytes (Trichophyton rubrum), but in the groin Candida albicans accounted for 49.9% of the fungal infections. Onychomycosis ranked third in prevalence (17.3% of all fungal infections). The main etiologic agent in the toenails was T. rubrum, but in fingernails C. albicans seems to be at least as important as T. rubrum. On the trunk (mainly the chest, especially in women) and buttocks C. albicans was again the main etiologic agent for fungal infections. Dermatophytes accounted for only 32.4% and 14.2% of the fungal infections on the buttock and trunk, respectively. On the buttock and trunk T. rubrum was the main etiologic agent as far as dermatophytes are concerned. On the trunk, Microsporum canis and M. ferrugineum were of some importance as well. The prevalence of tinea capitis was very low and accounted for only 0.7% of all fungal infections.

Cutaneous candidosis accounted for 30.3% of all fungal infections and is therefore important. On the chest, buttocks, groin and finger-nails, the prevalence of C. albicans is higher than that of dermatophytes.