Alternaria is a common saprophyte that is not usually pathogenic in humans. Alternarial onychomycosis is very rare and it is difficult to make a diagnosis of onycholycosis by moulds. In Korean literature, clinical findings of onychomycosis by Scopulariopsis brevicaulis, Aspergillus sp., Fusarium sp. were reported. But clinical finding of alternarial onychomycosis has not been reported. We report a probable case of alternarial onychomycosis in a 67-year-old Korean farmer. Some of the infected nails showed paronychia, onychia, loss of nail plate, black discoloration of proximal part of the nail plate and proximal nail folds. And some of them showed combined findings of proximal subungual onychomycosis and distal and lateral subungual onychomycosis. Repeated microscopic findings showing typical macroconidia and brownish hyphae of Alternaria were observed on three consecutive KOH smears with one-week interval. But cultures were not successful. Extraction of nail plates with oral antifungal and antibiotic treatment was only partially effective.
Aged ; Alternaria ; Aspergillus ; Diagnosis ; Fusarium ; Humans ; Hyphae ; Onychomycosis* ; Paronychia ; Scopulariopsis

BACKGROUND: Animals with zoophilic dermatophytes are important sources of dermatophytoses in man, because zoophilic dermatophytes are frequently transmitted directly or indirectly from domestic and wild animals. Trichophyton(T.) mentogrophytes has a wide range of hosts. Among these, rodents are well-known reservoirs in many other countries. In our country a few sporadic reports of incidence in experimental rats have been reported, but there is no study on the incidence in wild rodents in Korea. OBJECTIVE: The purpose of this study is to investigate the role of wild rodents as a host of dermatophytes and keratinophilic fungi in Korea. METHODS: Forty-nine wild rodents (Apodemus(A.) agrarius; 44, Crocidura spp; 5) were captured from 6 different regions of Kyungi-do with Sherman traps. Fungi were isolated by using the Mackenzie's brush technique. RESULTS: 1. Isolation rate of dermatophytes from wild rodents in Korea was 16.3%. 2. T. mentagrophytes was isolated from six A. agrarius (12.2%). Isolation rates from dorsum hairs, ventral hairs and feet were 4.5%, 9.1% and 9.1% respectively 3. Other dermatophytes and related keratinophilic fungi isolated were Chrysosporium spp.(65.3%), Scopulariopsis spp.(10.2%) and T. terrestre(4.1%). 4. Chrysosporium. was the most frequently isolated species from four out of six Kyonggi-do regions ranging 58.3%~83.3%. Scopulaiopsis was isolated the most in Kumgwang-myun Ansung-gun, and T. terrestre in Kimpo-gun. CONCLUSION: These results suggest that wild rodents, especially A. agrarius may be the important reservoirs of T. mentagrophytes and other keratinophilic fungi in Korea.
Animals ; Animals, Wild ; Arthrodermataceae* ; Chrysosporium ; Foot ; Fungi* ; Gyeonggi-do ; Hair ; Incidence ; Korea* ; Rats ; Rodentia* ; Scopulariopsis ; Tinea

BACKGROUND: The techniques that are currently used to diagnose nail infections, KOH and culture, can only provide indirect evidence of a fungal cause because false-negative and falsepositive results are high. The use of histologic examination can be of help for a more accurate and specific diagnosis. OBJECTIVE: This study was undertaken to investigate the characteristics of nail invasion and morphology in nail sections by 5 species of fungi including Trichophyton mentagrophutes var mentagrophytes, Trichophyton, rubrum, Candida albicans, Scopulariopsis brevicaulis, and Fusarium oxysporum. METHODS: Two in vitro methods for the study of nail invasion were used. In one method, those cultured fungi were inoculated on the ventral surface of the human nail clippings (direct nail inoculation method). In the other method, invasion of nail clippings by those fungi was induced in the continuous shaking liquid media (continuous shaking liquid culture method). RESULTS: 1. In direct nail inoculation method, the gross findings are similar to those obtained in routine culture media. By 1 week, the nail fragments were totally covered by a white fungal mycelium on gross examination. 2. Non-dermatophytes were slower invader of nail tissue than dermatohytes. Invasion was quicker and more extensive in the dystrophic nail. Full thickness invasion of the normal nail fragment was observed in 46.8+/-9.8 days. But it took 13.3+/-2.6 days to invade the dystrophic nail fragment (p<0.05). 3. This model showed the morphologic differences of three groups of fungi. Deramtolphytes gernerally showed regular, straight, septate and branched hyphae, which run parallel to the nail surface; C. albicans appeared as pseudofilaments running haphazardly within the nail; S. brevicaulis and F. oxysporum appeared as irregular, thicker hyphae without any spores. 4. By using the continuous shaking liqyid culture method, T. Mentagrophytes var mentagrophytes was only successful in nail invasion. CONCLUSION: The direct nail inoculation method is a simple method showing the dynamics of the nail invasion in vitro. Unlike to dermatolphytes, NDFF(non-dermatolphytic filamentous fungi) and Candida sp. could invade only dystrophic abnormal nail. Dermatophytes, Candida sp., and NDFF showed some differences in shape and arrangement fo the hyphae on the histopathologic sections. But they are not diagnostic to the species.
Arthrodermataceae ; Candida ; Candida albicans ; Culture Media ; Diagnosis ; Fungi* ; Fusarium ; Humans ; Hyphae ; Mycelium ; Nails, Malformed ; Running ; Scopulariopsis ; Spores ; Trichophyton

Scopulariopsis brevicaulis is a ubiquitous soil saprophyte that commonly causes onychomycosis, accounting for 1-10% of such infections. Rarely, it may be responsible for cutaneous lesions or more severe infections, especially after traumatic or surgical injuries. We report of a 54-year-old female patient who developed facial cellulitis caused by S. brevicaulis, which occurred one year after the patient underwent cosmetic surgery of the face. The patient suffered from febrile sense, pain and a growing mass lesion on her left cheek, which were diagnosed as facial cellulitis associated with foreign material that had been implanted at the time of cosmetic surgery. Three pus cultures from the mass lesion which performed at a week interval yielded the same S. brevicaulis. Surgical removal and drainage by using liposuction procedure resulted in a favorable outcome. To our knowledge this is the first report of S. brevicaulis infection associated with cosmetic surgery in Korea.
Cellulitis ; Cheek ; Drainage ; Female ; Humans ; Intraoperative Complications ; Korea ; Lipectomy ; Middle Aged ; Onychomycosis ; Scopulariopsis* ; Soil ; Suppuration ; Surgery, Plastic*

Although dermatophytes are still the main etiologic agents of onychomycosis, some species of nondermatophytic molds and yeasts are also capable of invading the nails. Scopulariopsis (S.) brevicaulis is a nondermatophytic mold which is saprophytic fungus in soil. We report four cases of toenail onychomycosis caused by S. brevicaulis in a 42-year-old male, a 46-year-old male, a 37-year-old male, and a 64-year-old male. Three patients presented with a typical distal subungual onychomycosis and one case was proximal subungual onychomycosis. Direct microscopic examination of scrapings on the potassium hydroxide preparation revealed fungal elements in all cases. Cultures from toenail lesions of the all patients on Sabouraud dextrose agar showed a typical brown colony with powdery surface of S. brevicaulis. Numerous branched conidiophores with chains of lemon-shaped conidia with rough walled were observed in slide culture and scanning electron microscopy (SEM). We confirmed S. brevicaulis by colony, light microscopic morphology and SEM.
Adult ; Agar ; Arthrodermataceae ; Fungi ; Glucose ; Humans ; Male ; Microscopy, Electron, Scanning ; Middle Aged ; Nails* ; Onychomycosis* ; Potassium ; Scopulariopsis* ; Soil ; Spores, Fungal ; Yeasts

Pacemaker lead infections are rare. There are only about 0.4%-1.1% of the patients who have been implanted permanent pacemakers suffering from serious infections which lead to endocarditis. Generally, removal of the infected pacemaker wire and lead, long-term anti-infection therapy, and implantation of a new pacemaker to another anatomic site are accepted approaches for these patients.
Device Removal ; Endocarditis ; drug therapy ; Humans ; Male ; Middle Aged ; Mycoses ; drug therapy ; Pacemaker, Artificial ; adverse effects ; Scopulariopsis

We report a case of the isolation of the Aspergillus versicolor complex, initially misidentified by morphological characteristics as the Scopulariopsis species, from a homograft with a bicuspidalized pulmonary valve. An eighteen-month-old female, who had critical pulmonary stenosis, underwent pulmonary valve replacement. On postoperative day 8, she developed a fever, which did not respond to empiric broad-spectrum antibiotics. While no definitive source was identified, a filamentous fungus was isolated from the thawed homograft tissue culture prior to implantation on the operation day. The colonies were powdery green with white edges on Sabouraud dextrose agar. Microscopic examination showed septate hyphae with branched conidiophores and chains of spiny conidia, which suggested Scopulariopsis species. After direct sequencing of the internal transcribed spacer (ITS) regions, the fungus was identified as the A. versicolor complex. To our knowledge, the isolation of the A. versicolor complex from a homograft valve has not been previously described. This case shows that laboratory staff should be aware that microscopic morphology of the A. versicolor complex can resemble that of a number of other genera, including Scopulariopsis species.
Agar ; Anti-Bacterial Agents ; Aspergillus ; Bicuspid ; European Continental Ancestry Group ; Female ; Fever ; Fungi ; Glucose ; Humans ; Hyphae ; Pulmonary Valve ; Pulmonary Valve Stenosis ; Scopulariopsis ; Spores, Fungal ; Transplantation, Homologous

BACKGROUND: Although there have been many studies about onychomycosis due to nondermatophytic molds (NDM), few studies about etiologic agents including NDM in onychomycosis have been reported in Korea. Objective: This study investigated onychomycosis due to NDM in the Gyeongju area of Korea. OBJECTIVE: This study investigated onychomycosis due to NDM in the Gyeongju area of Korea. METHODS: In the 10-year period from 1999~2009, we reviewed 59 patients with onychomycosis due to NDM. The etiologic agents were identified by cultures on Sabouraud's Dextrose agar with and without cycloheximide. In some cases, internal transcribed spacer sequence analysis was done. NDM isolated considered pathogens when the presence of fungal elements was identified by direct microscopy observation and in follow-up cultures yielding the same fungi. RESULTS: Onychomycosis due to NDM comprised 2.3% of all onychomycosis. Of the 59 patients with onychomycosis due to NDM, 84.7% were toenail onychomycosis and 15.3% were fingernail onychomycosis. The incidence rate was highest in the fifth decade (27.1%). The ratio of male to female patients was 1:1.6. The frequency of associated diseases, in descending order, was hypertension, diabetes mellitus, and cerebral hematoma. Distal and lateral subungual onychomycosis (86.4%) was the most common clinical type of onychomycosis. Aspergillus spp. was the most frequently isolated etiologic agent of onychomycosis due to NDM (83.0%). Other causative agents were Scopulariopsis brevicaulis (10.2%), Acremonium spp. (3.4%), Fusarium solani (1.7%), and Chaetomium globosum (1.7%). CONCLUSION: Because of the increase in onychomycosis due to NDM, we suggest the need of a careful mycological examination in patients with onychomycosis.
Acremonium ; Agar ; Aspergillus ; Chaetomium ; Cycloheximide ; Diabetes Mellitus ; Female ; Follow-Up Studies ; Fungi ; Fusarium ; Glucose ; Hematoma ; Humans ; Hypertension ; Incidence ; Korea ; Male ; Microscopy ; Nails ; Onychomycosis ; Scopulariopsis ; Sequence Analysis

The fungi on Meju are known to play an important role as degrader of macromolecule of soybeans. In order to elucidate the origin of fungi on traditional Meju, mycobiota of the air both inside and outside traditional Meju fermentation rooms was examined. From 11 samples of air collected from inside and outside of 7 Meju fermentation rooms, 37 genera and 90 species of fungi were identified. In outside air of the fermentation room, Cladosporium sp. and Cladosporium cladosporioides were the dominant species, followed by Cladosporium tenuissimum, Eurotium sp., Phoma sp., Sistotrema brinkmannii, Alternaria sp., Aspergillus fumigatus, Schizophyllum commune, and Penicillium glabrum. In inside air of the fermentation room, Cladosporium sp., Aspergillus oryzae, Penicillium chrysogenum, Asp. nidulans, Aspergillus sp., Cla. cladosporioides, Eurotium sp., Penicillium sp., Cla. tenuissimum, Asp. niger, Eur. herbariorum, Asp. sydowii, and Eur. repens were collected with high frequency. The concentrations of the genera Aspergillus, Eurotium, and Penicillium were significantly higher in inside air than outside air. From this result and those of previous reports, the origin of fungi present on Meju was inferred. Of the dominant fungal species present on Meju, Lichtheimia ramosa, Mucor circinelloides, Mucor racemosus, and Scopulariopsis brevicaulis are thought to be originated from outside air, because these species are not or are rarely isolated from rice straw and soybean; however, they were detected outside air of fermentation room and are species commonly found in indoor environments. However, Asp. oryzae, Pen. polonicum, Eur. repens, Pen. solitum, and Eur. chevalieri, which are frequently found on Meju, are common in rice straw and could be transferred from rice straw to Meju. The fungi grow and produce abundant spores during Meju fermentation, and after the spores accumulate in the air of fermentation room, they could influence mycobiota of Meju fermentation in the following year. This could explain why concentrations of the genera Aspergillus, Eurotium, and Penicillium are much higher inside than outside of the fermentation rooms.
Alternaria ; Aspergillus ; Aspergillus fumigatus ; Aspergillus nidulans ; Aspergillus oryzae ; Cladosporium ; Eurotium ; Fermentation* ; Fungi* ; Mucor ; Niger ; Oryza ; Penicillium ; Penicillium chrysogenum ; Schizophyllum ; Scopulariopsis ; Soybeans ; Spores ; Viperidae

Pet dogs have been considered to be involved in the contamination of indoor air by serving as a source of providing molds at houses. Currently, information on the molds originated from pet dogs is rarely available in Korea. The present study was carried out to obtain basic information on the fungi present on pet dogs. For this, fungal isolation was performed to the skin and hairs of 70 pet dogs at different houses and veterinary hospitals. A total of 44 fungal isolates were obtained from skin (27 isolates) and hairs (17 isolates) of the dogs investigated. Based on the observation of microstructures and colony morphology, and the ITS rDNA sequence analysis, the fungal isolates were identified at the level of genus. The identified isolates belong to the genera of Alternaria, Aspergillus, Beauveria, Chrysosporium, Cladosporium, Penicillium, Scopulariopsis, and Trichoderma. Among these genera, Aspergillus (25%), Cladosporium (23%) and Penicillium (20.5%) were 3 major genera. 63% of the 44 isolates showed color changes on dermatophyte test medium (DTM). When we tested the growth ability of 44 isolates at 37degrees C, 45% of the isolates were able to grow. These results show that pet dogs could carry fungi having a potentiality of affecting on human health.
Alternaria ; Animals ; Arthrodermataceae ; Aspergillus ; Beauveria ; Chrysosporium ; Cladosporium ; DNA, Ribosomal ; Dogs* ; Fungi* ; Hair ; Hospitals, Animal ; Humans ; Korea ; Penicillium ; Scopulariopsis ; Sequence Analysis ; Skin ; Trichoderma