Onychogryphosis due to Aspergillus niger in a poorly controlled type 2 diabetes mellitus

Yassine Merad Merad (1) , Malika Belkacemi (2) , Adila Bessaid (3) , Derouicha Matmour (4) , Zakaria Merad (5) , Mounia Medjber (6) , Fadia Bouroumi (7) , Khadija Abeidallah (8) , Dounia Benyelles (9) , Hanaa Ziani (10) , Kheira Talha (11) , Mounia Sekkouhi (12) , Bouhafs Bennadji (13) , Zouaoui Nadji (14) , Nadjet Belhadj (15)
(1) Central Laboratory,’ Hassani Abdelkader’ hospital; UDL Faculty of Medicine Laboratoire de synthèse de l’information environementale, UDL, Sidi-Bel-Abbes, 22000 Algeria; , Algeria
(2) Department of Hemobiology and Blood Transfusion, ‘Hassani Abdelkader’ Hospital, UDL faculty of Medicine , Algeria
(3) Department of Parasitology-Mycology, ‘Mustapha Bacha’ Hospital, Algiers , Algeria
(4) Central Laboratory,’ Hassani Abdelkader’ hospital; UDL Faculty of Medicine , Algeria
(5) Department of Pathology, ‘Hassani Abdelkader’ Hospital, UDL faculty of Medicine , Algeria
(6) Department of Psychiatric diseases, ‘Hassani Abdelkader’ Hospital, UDL Faculty of Medicine , Algeria
(7) Central Laboratory,’ Hassani Abdelkader’ hospital; UDL Faculty of Medicine Laboratoire de synthèse de l’information environementale, UDL, Sidi-Bel-Abbes, 22000 Algeria; , Algeria
(8) Central Laboratory,’ Hassani Abdelkader’ hospital; UDL Faculty of Medicine Laboratoire de synthèse de l’information environementale, UDL, Sidi-Bel-Abbes, 22000 Algeria; , Algeria
(9) Central Laboratory,’ Hassani Abdelkader’ hospital; UDL Faculty of Medicine Laboratoire de synthèse de l’information environementale, UDL, Sidi-Bel-Abbes, 22000 Algeria; , Algeria
(10) Central Laboratory,’ Hassani Abdelkader’ hospital; UDL Faculty of Medicine Laboratoire de synthèse de l’information environementale, UDL, Sidi-Bel-Abbes, 22000 Algeria; , Algeria
(11) Department of Endocrinology, ‘Hassani Abdelkader’ Hospital, UDL Faculty of Medicine , Algeria
(12) Department of Endocrinology, ‘Hassani Abdelkader’ Hospital, UDL Faculty of Medicine , Algeria
(13) Department of Internal Medicine, ‘Hassani Abdelkader’ Hospital, UDL Faculty of Medicine , Algeria
(14) Department of Internal Medicine, ‘Hassani Abdelkader’ Hospital, UDL Faculty of Medicine , Algeria
(15) Department of Internal Medicine, ‘Hassani Abdelkader’ Hospital, UDL Faculty of Medicine , Algeria
https://doi.org/10.52845/CMRO/2022/5-9-3

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Vol. 5 No. 09 (2022)
Keywords:
    diabetes mellitus, onychogryphosis, Aspergillus niger, moulds onyxis, onychomycosis
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Abstract

Onychogryphosis mostly affects the big toes. The nail plate rises upwards at first then deviates laterally, elderly patients, and homeless with marks of neglect are more commonly affected by this condition.
Here, we report a case of onychomycosis caused by Aspergillus niger in a 74-year-old female with type 2 diabetes mellitus discovered 8 month earlier, and managed by oral hypoglycemic. The patient presented with a black discoloration and a milky white base and onychogryphosis of the right big toenail.
Direct microscopic examination of scrapings after potassium hydroxide (KOH) preparation revealed dichotomous septate hyphae. Repeated cultures on Sabouraud's dextrose agar (SDA) without cycloheximide produced the same black velvety colonies.
Onychogryphosis is a particular nail condition to recognize and treat due to pain and consequences. Our patient was started on oral itraconazole at 500 mg twice daily, associated to amorolfine 5% lacquer for 3 months, which lead to partial remission after 8 weeks.
A careful clinical examination combined with mycological tests can be decisive in the diagnosis of fungal onychogryphosis, especially for patients with diabetes mellitus.

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Authors

Yassine Merad Merad
Central Laboratory,’ Hassani Abdelkader’ hospital; UDL Faculty of Medicine Laboratoire de synthèse de l’information environementale, UDL, Sidi-Bel-Abbes, 22000 Algeria;
yassinemerad8@gmail.com (Primary Contact)
Malika Belkacemi
Department of Hemobiology and Blood Transfusion, ‘Hassani Abdelkader’ Hospital, UDL faculty of Medicine
Adila Bessaid
Department of Parasitology-Mycology, ‘Mustapha Bacha’ Hospital, Algiers
Derouicha Matmour
Central Laboratory,’ Hassani Abdelkader’ hospital; UDL Faculty of Medicine
Zakaria Merad
Department of Pathology, ‘Hassani Abdelkader’ Hospital, UDL faculty of Medicine
Mounia Medjber
Department of Psychiatric diseases, ‘Hassani Abdelkader’ Hospital, UDL Faculty of Medicine
Fadia Bouroumi
Central Laboratory,’ Hassani Abdelkader’ hospital; UDL Faculty of Medicine Laboratoire de synthèse de l’information environementale, UDL, Sidi-Bel-Abbes, 22000 Algeria;
Khadija Abeidallah
Central Laboratory,’ Hassani Abdelkader’ hospital; UDL Faculty of Medicine Laboratoire de synthèse de l’information environementale, UDL, Sidi-Bel-Abbes, 22000 Algeria;
Dounia Benyelles
Central Laboratory,’ Hassani Abdelkader’ hospital; UDL Faculty of Medicine Laboratoire de synthèse de l’information environementale, UDL, Sidi-Bel-Abbes, 22000 Algeria;
Hanaa Ziani
Central Laboratory,’ Hassani Abdelkader’ hospital; UDL Faculty of Medicine Laboratoire de synthèse de l’information environementale, UDL, Sidi-Bel-Abbes, 22000 Algeria;
Kheira Talha
Department of Endocrinology, ‘Hassani Abdelkader’ Hospital, UDL Faculty of Medicine
Mounia Sekkouhi
Department of Endocrinology, ‘Hassani Abdelkader’ Hospital, UDL Faculty of Medicine
Bouhafs Bennadji
Department of Internal Medicine, ‘Hassani Abdelkader’ Hospital, UDL Faculty of Medicine
Zouaoui Nadji
Department of Internal Medicine, ‘Hassani Abdelkader’ Hospital, UDL Faculty of Medicine
Nadjet Belhadj
Department of Internal Medicine, ‘Hassani Abdelkader’ Hospital, UDL Faculty of Medicine
Merad, Y. M., Belkacemi , M. ., Bessaid, A. ., Matmour , D. ., Merad, Z. ., Medjber , M. ., Bouroumi , F. ., Abeidallah, K. ., Benyelles , D. ., Ziani , H. ., Talha , K. ., Sekkouhi , M. ., Bennadji , B. ., Nadji , Z. ., & Belhadj , N. . (2022). Onychogryphosis due to Aspergillus niger in a poorly controlled type 2 diabetes mellitus . Journal of Current Medical Research and Opinion, 5(09), 1380−1385. https://doi.org/10.52845/CMRO/2022/5-9-3
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