Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Art & Psychiatry
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Conference Oration
Conference Summary
Continuing Medical Education
Cosmetic Dermatology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
Editor Speaks
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Miscellaneous Letter
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News & Views
Observation Letter
Observation Letters
Original Article
Original Contributions
Pattern of Skin Diseases
Pediatric Dermatology
Pediatric Rounds
Presedential Address
Presidential Address
Presidents Remarks
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Study Letter
Study Letters
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapy Letter
Therapy Letters
View Point
What’s new in Dermatology
View/Download PDF

Translate this page into:

Letter to the Editor
doi: 10.4103/0378-6323.75001
PMID: 21220891

Onychomycosis due to Trichosporon mucoides

Sageerabanoo1 , A Malini1 , P Oudeacoumar2 , C Udayashankar2
1 Department of Microbiology, Aarupadai Veedu Medical College, Pondicherry, India
2 Department of Dermatology, Aarupadai Veedu Medical College, Pondicherry, India

Correspondence Address:
A Malini
Department of Microbiology, Aarupadai Veedu Medical College, Kirumampakkam, Pondicherry - 607 402
How to cite this article:
S, Malini A, Oudeacoumar P, Udayashankar C. Onychomycosis due to Trichosporon mucoides. Indian J Dermatol Venereol Leprol 2011;77:76-77
Copyright: (C)2011 Indian Journal of Dermatology, Venereology, and Leprology


Onychomycosis is the fungal infection of nails caused by dermatophytes, yeasts, and non-dermatophytic molds where dermatophytes account for nearly 70% of cases. [1] Onychomycosis is one of the most common nail diseases and about 1.5% to 15% of patients presenting to dermatologists have this condition. [2] Yeasts earlier regarded as contaminants are now increasingly being recognized as pathogens in fingernails. [1] Candida species are the most common yeasts causing nail infection among which Candida albicans accounts for 70% of cases. [1],[2] Trichosporon species have rarely been implicated as causative agents of onychomycosis. Here we report a case of onychomycosis due to Trichosporon mucoides. To the best of our knowledge this is the first report of onychomycosis due to T. mucoides.

A 31-year-old male, electrician by occupation, presented to the dermatology OPD of our hospital with the complaint of brownish discoloration of all the ten finger nails for the past 1 year.

On examination all the fingernails were brownish black in color. There was distal onycholysis in all the finger nails. Subungual hyperkeratosis was also seen in most of the nails [Figure - 1].

Figure 1 :Brownish discoloration and distal onycholysis involving all fingernails

Multiple specimens of nail scrapings and nail clippings from the different parts of the nail were collected after cleansing the nail area with alcohol. Direct examination of the nail clippings with 40% KOH kept overnight showed septate hyphae. The nail clippings were inoculated on two sets of Sabouraud′s dextrose agar (SDA) with antibiotics and SDA with cycloheximide, which were incubated at room temperature (RT) and at 37 o C. SDA with antibiotics showed white pasty, feathery colony after 2 days of incubation both at RT and 37 o C [[Figure - 2], inset]. SDA with cycloheximide did not show any growth. Lactophenol cotton blue (LPCB) tease mount of the culture showed arthroconidia. On cornmeal agar it showed arthroconidia and blastoconidia [Figure - 2]. It was urease positive. Sugar assimilation test on yeast nitrogen base agar showed that it assimilated galactitol, sorbitol, and arabinitol [Figure - 3].

Figure 2 :White feathery and pasty colony of Trichosporon mucoides on SDA (inset). LPCB mount of the culture on cornmeal agar showing the arthroconidia and blastoconidia (arrow)
Figure 3 :Sugar assimilation test on yeast nitrogen base agar showing the assimilation of galactitol, sorbitol, and arabinitol by T. mucoides

Based on the above findings, it was identified as T. mucoides. [3] Repeat culture of the nail sample yielded the same organism. The patient was started on oral fluconazole 150 mg once a week for 9 months but was lost to follow-up.

Onychomycosis due to yeast and molds constitute about 5% of cases. Yeasts due to the lack of keratinolytic activity are considered rarely as primary pathogens. [4] Factors such as aging, immunodeficiency, trauma, hyperhydrosis, socioeconomic status, climatic conditions, and paronychia are predisposing to onychomycosis. [1],[4] In our case the climatic conditions causing excessive sweating and his occupation could have been the predisposing factors.

Trichosporon species are found in soil and water and also occurs as normal flora in human skin. [3] The role of T. mucoides as the causative agent was established by isolation of the same organism from a repeat nail sample. Trichosporon species are emerging pathogens in immunocompromised individuals. Seven species of Trichosporon are known to cause human infections - T. asahii (called as T. beigilii earlier) and T. mucoides are associated with life-threatening infections and T. inkin, T. asteroides, T. cutaneum, T. ovoides and T. louberi are associated with superficial infections. [4]

Trichosporon species are differentiated by the sugar assimilation pattern on yeast nitrogen base agar. Galactitol, sorbitol, and arabinitol can be used to differentiate between the species. T. asahii being the most common species assimilates only arabinitol. T. mucoides assimilates galactitol, sorbitol, and arabinitol. T. cutaneum assimilates arabinitol and sorbitol. T. inkin and T. ovoides do not assimilate any of these three sugars. [3] Hence it was identified as T. mucoides in our case.

T. asahii is the most common species causing human infections. It is known to cause white piedra and less commonly onychomycosis in an immunocompetent host. In an immunodeficient host it causes systemic infections like pneumonia, glomerulonephritis, brain abscess, and endocarditis including onychomycosis. [3]

T. mucoides causing a disseminated infection in a transplant recipient has been described earlier. [5] To the best of our knowledge, T. mucoides causing nail infection has not been reported. Hence, we report this interesting case.

Kaur R, Kashyap B, Bhalla P. Onychomycosis-epidemiology, diagnosis and management. Indian J Med Microbiol 2008;26:108-16.
[Google Scholar]
Geramishoar M, Zomorodian K, Emami M, Tarazoei B, Saadat F. Study and identification of the etiological agents of onychomycosis in Tehran, capital of Iran. Iran J Public Health 2002;31:100-4.
[Google Scholar]
Chander J. Miscellaneous opportunistic mycosis. In: Chander J, editor. Textbook of Medical Mycology. 3 rd ed. New Delhi: Mehta publishers; 2009. p. 388-90.
[Google Scholar]
D'Antonio D, Romano F, Iacone A, Violante B, Fazii P, Pontieri E, et al. Onychomycosis caused by Blastoschizomyces capitus. J Clin Microbiol 1999;37:2927-30.
et al. Onychomycosis caused by Blastoschizomyces capitus. J Clin Microbiol 1999;37:2927-30.'>[Google Scholar]
Nettles RE, Nichols LS, Bell-McGuinn K, Pipeling MR, Scheel PJ Jr, Merz WG. Successful treatment of Trichosporon mucoides infection with fluconazole in a heart and kidney transplant recipient. Clin Infect Dis 2003;36:e63-6.
[Google Scholar]

Fulltext Views

PDF downloads
Show Sections