Escobar Martha Lucía, Carmona-Fonseca Jaime
Facultad de Medicina, Universidad de Antioquia, Carrera 51D #62-29, piso 2, Medellín, Colombia.
Rev Iberoam Micol. 2003 Mar;20(1):6-10.
Between 1990 and 2000, The Medical Mycology Laboratory at University of Antioquia (Medellín, Colombia), attended 4621 patients, with nail dystrophies. We used the direct test and culture of nail samples for diagnostic purposes. This report includes 310 patients, 7% (310/4621), with positive cultures for the same non-dermathophyte fungi, in five or more places of inoculation. From the 310 positive cultures, 284 (92%) were positive in direct test. No characteristic morphology for any of the genera could be detected. Until 1989 we had an average of 9 cases per year and between 1990 and 2000 we found 28 cases per year (an increase of 211%). The implicated genera were: Fusarium 50%, Nattrassia 31%, Aspergillus and Dendrophoma 7% each, Penicillium and Scopulariopsis contributed with 2% each, and Acremonium was found in less of 1% of cases. The general prevalence of onychomycosis due to non-dermatophytic fungi was about 12,4% between 1990-2000. This report describes the main epidemiological characteristics found, comparing them with results from other authors, and defines the basic profile of affected patients: adults (31-40 years old) who use occlusive shoes (trainers) and practice sport, which predispose to hyperhydrosis and consequently to onychomycosis. The course of the disease takes in average 30 months in both sexes. The percentage of onychomycosis found was 62% for women and 38% for men.
1990年至2000年间,安蒂奥基亚大学(哥伦比亚麦德林)医学真菌学实验室诊治了4621例甲营养不良患者。我们采用指甲样本的直接检测和培养进行诊断。本报告涵盖310例患者,占7%(310/4621),其在五个或更多接种部位的培养结果显示为同一非皮肤癣菌阳性。在310份阳性培养物中,284份(92%)直接检测呈阳性。未检测到任何属的特征形态。1989年之前,我们平均每年有9例病例,而在1990年至2000年间,我们每年发现28例(增长了211%)。涉及的属包括:镰刀菌属占50%,纳特拉菌属占31%,曲霉属和树状多隔孢属各占7%,青霉属和帚霉属各占2%,顶孢霉属在不到1%的病例中被发现。1990 - 2000年间,非皮肤癣菌引起的甲真菌病总体患病率约为12.4%。本报告描述了所发现的主要流行病学特征,并与其他作者的结果进行比较,同时定义了受影响患者的基本特征:31 - 40岁的成年人,他们穿着封闭式鞋子(运动鞋)并进行体育活动,这易导致多汗,进而引发甲真菌病。该病病程在男女中平均为30个月。发现女性甲真菌病的比例为62%,男性为38%。