Fungal infection of nails or onychomycosis is non-life threatening disease commonly caused by dermatophytes. The infection is also caused by non dermatophytes like yeasts and non dermatophytic moulds. There are various factors which play an important role in causation of onychomycosis. These predisposing factors are aging, fall in the immune status, diabetes, immunosuppressive therapy for cancer and organ transplantation, HIV, long term antibiotics, occlusive footwear, immune deficiency diseases and occupations involving continuous contact with water, for instance swimmers, fishermen, clothes and dish washers. Climatic conditions also play an important role in the causation of onychomycosis. The present study was carried out in a tertiary care hospital for a period of 8 months. The aim of the study was to determine various predisposing factors and causative agents of onychomycosis. The sample was placed in a sterile petridish and transported to microbiology laboratory. The sample was then divided into two parts, one for direct microscopy under high power objective using 20-25% KOH and the other part for culture on Sabouraud’s dextrose agar (SDA) with cyclohexamide. The cultures were kept at 25°C and 37°C for up to six weeks. Confirmation of the organism was done based on morphology of fungus in LPCB (Lactose phenol cotton blue) mount, culture of fungus on SDA and slide culture. Among the 68 patients selected based on clinical presentation, 26 yielded fungal pathogens in culture. A total of 15 (57.6%) isolates were dermatophytes and 11 (42.3%) were non dermatophytes. Among the dermatophytes, 7 (26.9%) cases yielded Trichophyton which was the most commonly isolated fungus followed by Microsporum 5 (19.2%), Epidermophyton 3 (11.5%). Among the non dermatophytes, candida was isolated from 3 (11.5%) cases, Aspergillus was isolated from 2 (7.6%), Pyrenochaeta from 2 (7.6%) cases, Curvularia from 2 (7.6%) cases and only 1 (3.8%) case yielded Fusarium. It was seen that males were more prone to onychomycosis compared to females. Incidence of toe nail onychomycosis was higher compared to finger nail onychomycosis. This study suggests that the isolation of the organism with culture is very important as it will aid the clinician to rule out bacterial causes and choose appropriate antifungal therapy.

Download this article as