|Year : 2016 | Volume
| Issue : 2 | Page : 257-258
Onychomycosis of toenails caused by Syncephalastrum racemosum: A rare non-dermatophyte mould
N Jindal, N Kalra, S Arora, D Arora, R Bansal
Department of Microbiology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
|Date of Submission||09-Apr-2015|
|Date of Acceptance||07-Sep-2015|
|Date of Web Publication||14-Apr-2016|
Department of Microbiology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Jindal N, Kalra N, Arora S, Arora D, Bansal R. Onychomycosis of toenails caused by Syncephalastrum racemosum: A rare non-dermatophyte mould. Indian J Med Microbiol 2016;34:257-8
|How to cite this URL:|
Jindal N, Kalra N, Arora S, Arora D, Bansal R. Onychomycosis of toenails caused by Syncephalastrum racemosum: A rare non-dermatophyte mould. Indian J Med Microbiol [serial online] 2016 [cited 2019 Jun 20];34:257-8. Available from: http://www.ijmm.org/text.asp?2016/34/2/257/176844
Apropos, an informative report - 'A rare case of subcutaneous mucormycosis due to Syncephalastrum racemosum: Case report and review of literature' which was published in the fourth issue of 2014 of your journal,  we wish to submit a case report of onychomycosis caused by this uncommon but ubiquitous saprophytic fungus of low human pathogenicity. Only a few cases of onychomycosis caused by S. racemosum have been documented so far. ,
A 48-year-old male, construction worker, presented to skin OPD with discoloured and thickened nails of great toes of both the feet and of the second toenail of the right foot of 8 months duration. He gave the history of trauma to right toenail at the work site, following which yellowish discolouration and thickening of nails of great toes of both the feet and subsequently of the second toenail of right foot were developed. He had a medical history of bronchial asthma for which he was taking corticosteroids on and off for the last 4 years. He was not diabetic and there was no history of use of any antifungal agent. Nail clippings and scrapings were collected from the affected nails and were subjected to wet mount examination using 40% potassium hydroxide (KOH) and fluorescent microscopy using calcofluor white staining [Figure 1]a. The nail clippings were also cultured on two slopes of Sabouraud's dextrose agar (SDA) with and without cycloheximide, which were incubated at 27°C. Both the KOH mount and fluorescent microscopy revealed wide, ribbon-like aseptate fungal hyphae. Culture growth on SDA without cycloheximide revealed abundant, erected mycelium within 72 h. The surface colour of the cottony to wooly growth was at first greyish white and then turned dark grey and the centre became black. The reverse of colony showed no change in the colour of SDA. There was no growth on SDA supplemented with cycloheximide. Lactophenol cotton blue stain showed wide, ribbon-like aseptate, branched fungal hyphae and sporangiophores, which terminated in swollen vesicles with radial merosporangiae filled with spores [Figure 1]b. Based on the above morphological features, the isolate was identified as S. racemosum. It was differentiated from Aspergillus flavus on the basis of the structure of the hyphae and the colony morphology. When the patient visited again after 1-week, more nail clippings were collected and examined again in wet mount (KOH mount), fluorescent microscopy and were cultured, growth of non-dermatophyte mould with similar characteristics as described earlier was obtained. A diagnosis of onychomycosis due to S. racemosum was made and the patient was started on fluconazole 150 mg orally for 4 weeks and is under follow-up.
|Figure 1: (a) Calcoflor white smear showing broad aseptate hyphae and (b) Lactophenol cotton blue mount showing broad aseptate hyphae and sporangiophores terminating in swollen vesicles with radial merosporangiae filled with spores (×400)|
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Recently, a case of total dystrophic onychomycosis of fingernails caused by S. racemosum has been reported by Kumaran and Rudramurthy from India.  Gupta et al. reported that non-dermatophyte moulds are increasing in onychomycosis.  may be due to improved techniques of the detection of fungal infections.
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| ~ References|| |
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Pavlovic MD, Bulajic N. Great toenail onychomycosis caused by Syncephalastrum racemosum
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Kumaran R, Rudramurthy KG. Total dystrophic onychomycosis caused by Syncephalastrum recemosum
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Gupta AK, Ryder JE, Baran R, Summerbell RC. Non-dermatophyte onychomycosis. Dermatol Clin 2003;21:257-68.