Distal and lateral subungual onychomycosis of the finger nail in a neonate: A rare case

Supram Hosuru Subramanya, Saujan Subedi, Yang Metok, Ajay Kumar, Peralam Yegneswaran Prakash, Niranjan Nayak

Research output: Contribution to journalArticle

Abstract

Background: Onychomycosis is extremely rare in neonates, infrequently reported in children and is considered to be exclusively a disease of adults. Case presentation: We, herein report a case of fingernail onychomycosis in a 28-day-old, healthy, male neonate. The child presented with a history of yellowish discoloration of the fingernail of the left hand for one week. The etiological agent was demonstrated both by microscopic examination and culture of nail clippings. The isolate grown on culture was identified as Candida albicans by phenotypic characteristics and by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Antifungal sensitivity testing was performed by broth dilution method as per the Clinical & Laboratory Standards Institute guidelines. An oral swab culture of the child also yielded C. albicans with the same antibiogram as the nail isolate. The case was diagnosed as distal and lateral subungual candida onychomycosis of severity index score 22 (severe) and was treated with syrup fluconazole 6 mg/kg body weight/week and 5% amorolfine nail lacquer once/week for three months. After three months of therapy, the patient completely recovered with the development of a healthy nail plate. Conclusions: The case is presented due to its rarity in neonates which, we suppose is the first case report of onychomycosis from Nepal in a 28-day-old neonate. Oral colonization with pathogenic yeasts and finger suckling could be risk factors for neonatal onychomycosis.

Original languageEnglish
Article number168
JournalBMC Pediatrics
Volume19
Issue number1
DOIs
Publication statusPublished - 27-05-2019

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Onychomycosis
Nails
Fingers
Newborn Infant
Candida albicans
Lacquer
Nepal
Fluconazole
Microbial Sensitivity Tests
Candida
Mass Spectrometry
Lasers
Hand
Yeasts
Body Weight
Guidelines

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Subramanya, Supram Hosuru ; Subedi, Saujan ; Metok, Yang ; Kumar, Ajay ; Prakash, Peralam Yegneswaran ; Nayak, Niranjan. / Distal and lateral subungual onychomycosis of the finger nail in a neonate : A rare case. In: BMC Pediatrics. 2019 ; Vol. 19, No. 1.
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abstract = "Background: Onychomycosis is extremely rare in neonates, infrequently reported in children and is considered to be exclusively a disease of adults. Case presentation: We, herein report a case of fingernail onychomycosis in a 28-day-old, healthy, male neonate. The child presented with a history of yellowish discoloration of the fingernail of the left hand for one week. The etiological agent was demonstrated both by microscopic examination and culture of nail clippings. The isolate grown on culture was identified as Candida albicans by phenotypic characteristics and by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Antifungal sensitivity testing was performed by broth dilution method as per the Clinical & Laboratory Standards Institute guidelines. An oral swab culture of the child also yielded C. albicans with the same antibiogram as the nail isolate. The case was diagnosed as distal and lateral subungual candida onychomycosis of severity index score 22 (severe) and was treated with syrup fluconazole 6 mg/kg body weight/week and 5{\%} amorolfine nail lacquer once/week for three months. After three months of therapy, the patient completely recovered with the development of a healthy nail plate. Conclusions: The case is presented due to its rarity in neonates which, we suppose is the first case report of onychomycosis from Nepal in a 28-day-old neonate. Oral colonization with pathogenic yeasts and finger suckling could be risk factors for neonatal onychomycosis.",
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Distal and lateral subungual onychomycosis of the finger nail in a neonate : A rare case. / Subramanya, Supram Hosuru; Subedi, Saujan; Metok, Yang; Kumar, Ajay; Prakash, Peralam Yegneswaran; Nayak, Niranjan.

In: BMC Pediatrics, Vol. 19, No. 1, 168, 27.05.2019.

Research output: Contribution to journalArticle

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