Abstract

LIZANO-CALVO, Mauricio; BRENES-ANGULO, Arturo  and  GOMEZ-ALPIZAR, Luis. First case of onychomycosis caused by Cylindrocarpon lichenicola in an immunosuppressed patient in Costa Rica. Acta méd. costarric [online]. 2013, vol.55, n.4, pp.199-204. ISSN 0001-6002.

Background: Onychomycosis is a fungal infection of nails that can be caused by dermatophytes, yeasts and non-dermatophyte filamentous fungi. The aim of this study was to perform a morphological and molecular identification of an isolate obtained from the nail of the middle finger of the right hand of an immunosuppressed patient, who underwent renal transplant. Methods: The sample was directly analyzed under the microscope in 40% KOH and cultured on Sabouraud glucose agar and Mycosel agar to study the macro and microscopic features of the colony. The isolated fungus was molecularly characterized by Polymerase chain reaction (PCR) amplification and sequencing of the internal transcribed spacer (ITS) region of the ribosomal DNA genes and a portion of translation elongation factor 1-alpha (TEF). Nucleotide sequences of each region were compared with the sequences reported in the GenBank database of the National Center for Biotechnology Information (NCBI). Results: The macro and microscopic features of the colony were consistent with those described for Cylindrocarpon lichenicola (synonym: Fusarium lichenicola). The nucleotide sequence, both of the ITS region (544 bp) as well as that of the TEF gene (710 pb), showed a 100% nucleotide identity to sequences of Fusarium lichenicola. Conclusion: C. lichenicola was identified associated to onychomycosis in an immunosuppressed patient in Costa Rica for the first time. These patients should be properly instructed about potential sources of infectious agents and the risks of gardening and agriculture activities.

Keywords : Onychomycosis; non-dermatophyte fungi; immunosuppressed patient.

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