ASPERGILLUS VERSICOLOR AS CAUSE OF ONYCHOMYCOSIS - REPORT OF 12 CASESAND SUSCEPTIBILITY TESTING TO ANTIFUNGAL DRUGS

Background Onychomycoses caused by opportunistic moulds are not well u nderstood, and many are due to Scopulariopsis brevicaulis and other sp ecies. Aspergillus versicolor is not documented as an etiological agen t in most studies. We have found an increasing prevalence of this spec ies which is involved in 5.8% of all fungal infections of toe nails. O bjective To study the clinical and mycological characteristics of the onychomycosis caused by A. versicolor and the in vitro susceptibility of this mould to antifungal agents. Results Onychomycosis due to A. ve rsicolor is mainly seen in people over 60 and presents with chronic in volvement of the big toe nails. Predisposing factors are not always pr esent and the infection does not respond to conventional topical antif ungals. In vitro, A. versicolor has been shown to be resistant to gris eofulvin and fluconazole as well as to amphotericin B, whereas MICs fo r itraconazole and ketoconazole are variable but within a range of 0.5 0-4.0 mu g/ml; on the contrary, MICs for terbinafine are very low (<0. 125 mu g/ml). Discussion Aspergillus versicolor could be considered as an emergent pathogen causing toenail onychomycosis. Local treatment s eems not to be effective. Of the various systemic antifungal agents st udied terbinafine appears to be the most effective in treating onychom ycosis. (C) 1998 Elsevier Science B.V. All rights reserved