Onychomycosis in the Military Hospital of Marrakesh: A Five-year Experience

Fatima Babokh; Zineb Nassiri; El Mostafa El Mezouari; Redouane Moutaj

doi:doi:10.11648/j.ajlm.20210604.13

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Onychomycosis in the Military Hospital of Marrakesh: A Five-year Experience

Fatima Babokh, Zineb Nassiri, El Mostafa El Mezouari, Redouane Moutaj

Published in American Journal of Laboratory Medicine (Volume 6, Issue 4)

Received: 25 July 2021 Accepted: 10 August 2021 Published: 27 August 2021

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Abstract

Onychomycosis is a nail fungal infection caused by dermatophytes, becoming one of the most frequent reasons for consultation in mycological dermatology in Morocco. The purpose of this work is to describe the epidemiology of onychomycosis and to specify the most frequently isolated fungal agents in the Avicenna Military Hospital of Marrakesh. This is a retrospective study that included 875 patients and took place in the Avicenna Military Hospital of Marrakesh over a period of 5 years. Direct examination on a slide with a coverslip after clarification with potassium hydroxide (KOH 30%), as well as culture on Sabouraud media supplemented with chloramphenicol and chloramphenicol with cycloheximide were systematically carried out. Incubation was carried out in 20-25°C for dermatophytes and 37°C for yeasts and molds. The tubes were regularly controlled (twice a week) for at least four weeks before giving negative results. Between January 2015 and July 2019, 875 patients were enrolled in this study. Sex ratio (M:F) was 1.06. The average age was 48 years. Toenails were affected in 683 cases (78%), fingernails in 192 cases (21.9%), and both fingernails and toenails in 120 cases (13.7%). Pachyonychia was present in 63% of the cases (551/875), subungual hyperkeratosis in 50.8% of the cases (444/875) and xanthonychia in 43% of them (376/875). 61% (625 / 875) of direct examinations were positive, of which 83% (522/625) were confirmed by positive culture. Dermatophytes were isolated in 86.8% of the cases (n=759), yeasts in 13% (n=113) and molds in 0.2% of the cases (n=2). Candida albicans was the only identified yeast in this series (13%), found mainly in fingernails. In addition, toenail onyxis was mainly caused by dermatophytes. Trichophyton rubrum and Trichophyton mentagrophytes var interdigital represented 80.8% and 6% of isolated dermatophytes, respectively. This work attests the contribution of mycological examination to the confirmation of fungal origin of onychopathies and the treatment orientation. Trichophyton rubrum was isolated in the majority of our cases.

Published in	American Journal of Laboratory Medicine (Volume 6, Issue 4)
DOI	10.11648/j.ajlm.20210604.13
Page(s)	66-69
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Onychomycosis, Trichophyton rubrum, Candida albicans

References

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[2]	Société francaise de dermatologie, Recommandations Onychomycose. Modalités de diagnostic et prise en charge. Ann Dermatol Venereol 2007; 134: 7–16.
[3]	Halim F. El Kadioui, M. Soussi Abdallaoui. Les onychomycoses à Casablanca (Maroc). Journal de Mycologie Médicale (2013) 23, 9—14.
[4]	E. A. Kouotou, F. A. Kechia, Y. Iwewe Somo, U. Nguena Feungue N. J. R. Nansseu c, R. Moyou Somo. Profil mycologique des onychomycoses vues en consultation de dermatologie à Yaoundé, Cameroun.j.mycmed.2017.03.002.
[5]	Ben Youssef, A. Kallel Z. Azaiz, S. Jemel, N. Bada, A. Chouchen, N. Belhadj-Salah, N. Fakhfakh, S. Belhadj, K. Kallel. Onychomycosis: Which fungal species are involved? Experience of the Laboratory of Parasitology-Mycology of the Rabta Hospital of Tunis A. Journal de Mycologie Médicale. Volume 28, Issue 4, December 2018, Pages 651-654.
[6]	Manasa N Kayarkatte, Archana Signal, Deepika Pandhi, Shukla Das. linico-mycological Study of Onychomycosis in a Tertiary Care hospital-A Cross-Sectional Study. Mycoses 2020 Jan; 63 (1): 113-118.
[7]	Nzenze S, Ngoungou EB, Mabika M, Bouyou MK, Avome IM, Kombila M. Les onychomycoses au Gabon: aspects cliniques et mycologiques. J Mycol Med 2011; 21: 248—55.
[8]	Zagnoli A, Chevalier B, Sassolas B. Dermatophyties et dermatophytes. In: EMC, Pediatrie, Maladies infectieuses. 2005; 1–14.
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[10]	P. Zukervar, G. Dabin, T. Secchi, A. Petiot-Roland, N. Mathon, M. Maccari, B. Pincemaille, A. Colcombet-Navarranne a, G. Rigot-Muller a, V. Batut a, S. Picot b, A.-L. Bienvenu b. Étude des onychomycoses en médecine de ville dans la région lyonnaise, France. Journal de Mycologie Médicale (2011) 21, 118—122.
[11]	M. C. Seck, D. Ndiaye, K. Diongue, M. Ndiay, A. S. Badiane, D. Sow, K. Sylla, R. Tine, J. L. Ndiaye. Profil mycologique des onychomycoses à Dakar (Sénégal) Journal de Mycologie Médicale (2014) 24, 124—128.
[12]	Larissa Lopes Milane Bentine, Lucas Xavier Bonfietti2 & Maria Walderez Szeszs, Marcia de Souza Carvalho Melhem2. Onychomycoses in a Military Population in Brazil. Curr Fungal Infect Rep (2017) 11: 171–175.
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[14]	S. Nzenze Afène, E. B. Ngoungou, M. Mabika Mamfoumbi, M. K. Bouyou Akotet, I. M. Avome Mba, M. Kombila; Onychomycosis in Gabon: Clinical and mycological dataJournal de Mycologie Médicale (2011) 21, 248—255.

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APA Style

Fatima Babokh, Zineb Nassiri, El Mostafa El Mezouari, Redouane Moutaj. (2021). Onychomycosis in the Military Hospital of Marrakesh: A Five-year Experience. American Journal of Laboratory Medicine, 6(4), 66-69. https://doi.org/10.11648/j.ajlm.20210604.13

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ACS Style

Fatima Babokh; Zineb Nassiri; El Mostafa El Mezouari; Redouane Moutaj. Onychomycosis in the Military Hospital of Marrakesh: A Five-year Experience. Am. J. Lab. Med. 2021, 6(4), 66-69. doi: 10.11648/j.ajlm.20210604.13

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AMA Style

Fatima Babokh, Zineb Nassiri, El Mostafa El Mezouari, Redouane Moutaj. Onychomycosis in the Military Hospital of Marrakesh: A Five-year Experience. Am J Lab Med. 2021;6(4):66-69. doi: 10.11648/j.ajlm.20210604.13

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@article{10.11648/j.ajlm.20210604.13,
  author = {Fatima Babokh and Zineb Nassiri and El Mostafa El Mezouari and Redouane Moutaj},
  title = {Onychomycosis in the Military Hospital of Marrakesh: A Five-year Experience},
  journal = {American Journal of Laboratory Medicine},
  volume = {6},
  number = {4},
  pages = {66-69},
  doi = {10.11648/j.ajlm.20210604.13},
  url = {https://doi.org/10.11648/j.ajlm.20210604.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajlm.20210604.13},
  abstract = {Onychomycosis is a nail fungal infection caused by dermatophytes, becoming one of the most frequent reasons for consultation in mycological dermatology in Morocco. The purpose of this work is to describe the epidemiology of onychomycosis and to specify the most frequently isolated fungal agents in the Avicenna Military Hospital of Marrakesh. This is a retrospective study that included 875 patients and took place in the Avicenna Military Hospital of Marrakesh over a period of 5 years. Direct examination on a slide with a coverslip after clarification with potassium hydroxide (KOH 30%), as well as culture on Sabouraud media supplemented with chloramphenicol and chloramphenicol with cycloheximide were systematically carried out. Incubation was carried out in 20-25°C for dermatophytes and 37°C for yeasts and molds. The tubes were regularly controlled (twice a week) for at least four weeks before giving negative results. Between January 2015 and July 2019, 875 patients were enrolled in this study. Sex ratio (M:F) was 1.06. The average age was 48 years. Toenails were affected in 683 cases (78%), fingernails in 192 cases (21.9%), and both fingernails and toenails in 120 cases (13.7%). Pachyonychia was present in 63% of the cases (551/875), subungual hyperkeratosis in 50.8% of the cases (444/875) and xanthonychia in 43% of them (376/875). 61% (625 / 875) of direct examinations were positive, of which 83% (522/625) were confirmed by positive culture. Dermatophytes were isolated in 86.8% of the cases (n=759), yeasts in 13% (n=113) and molds in 0.2% of the cases (n=2). Candida albicans was the only identified yeast in this series (13%), found mainly in fingernails. In addition, toenail onyxis was mainly caused by dermatophytes. Trichophyton rubrum and Trichophyton mentagrophytes var interdigital represented 80.8% and 6% of isolated dermatophytes, respectively. This work attests the contribution of mycological examination to the confirmation of fungal origin of onychopathies and the treatment orientation. Trichophyton rubrum was isolated in the majority of our cases.},
 year = {2021}
}

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TY - JOUR
T1 - Onychomycosis in the Military Hospital of Marrakesh: A Five-year Experience
AU - Fatima Babokh
AU - Zineb Nassiri
AU - El Mostafa El Mezouari
AU - Redouane Moutaj
Y1 - 2021/08/27
PY - 2021
N1 - https://doi.org/10.11648/j.ajlm.20210604.13
DO - 10.11648/j.ajlm.20210604.13
T2 - American Journal of Laboratory Medicine
JF - American Journal of Laboratory Medicine
JO - American Journal of Laboratory Medicine
SP - 66
EP - 69
PB - Science Publishing Group
SN - 2575-386X
UR - https://doi.org/10.11648/j.ajlm.20210604.13
AB - Onychomycosis is a nail fungal infection caused by dermatophytes, becoming one of the most frequent reasons for consultation in mycological dermatology in Morocco. The purpose of this work is to describe the epidemiology of onychomycosis and to specify the most frequently isolated fungal agents in the Avicenna Military Hospital of Marrakesh. This is a retrospective study that included 875 patients and took place in the Avicenna Military Hospital of Marrakesh over a period of 5 years. Direct examination on a slide with a coverslip after clarification with potassium hydroxide (KOH 30%), as well as culture on Sabouraud media supplemented with chloramphenicol and chloramphenicol with cycloheximide were systematically carried out. Incubation was carried out in 20-25°C for dermatophytes and 37°C for yeasts and molds. The tubes were regularly controlled (twice a week) for at least four weeks before giving negative results. Between January 2015 and July 2019, 875 patients were enrolled in this study. Sex ratio (M:F) was 1.06. The average age was 48 years. Toenails were affected in 683 cases (78%), fingernails in 192 cases (21.9%), and both fingernails and toenails in 120 cases (13.7%). Pachyonychia was present in 63% of the cases (551/875), subungual hyperkeratosis in 50.8% of the cases (444/875) and xanthonychia in 43% of them (376/875). 61% (625 / 875) of direct examinations were positive, of which 83% (522/625) were confirmed by positive culture. Dermatophytes were isolated in 86.8% of the cases (n=759), yeasts in 13% (n=113) and molds in 0.2% of the cases (n=2). Candida albicans was the only identified yeast in this series (13%), found mainly in fingernails. In addition, toenail onyxis was mainly caused by dermatophytes. Trichophyton rubrum and Trichophyton mentagrophytes var interdigital represented 80.8% and 6% of isolated dermatophytes, respectively. This work attests the contribution of mycological examination to the confirmation of fungal origin of onychopathies and the treatment orientation. Trichophyton rubrum was isolated in the majority of our cases.
VL - 6
IS - 4
ER -

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Author Information

Fatima Babokh

Department of Parasitology-Mycology, Military Hospital Avicenne, Marrakech, Morocco
Zineb Nassiri

Department of Parasitology-Mycology, Military Hospital Avicenne, Marrakech, Morocco
El Mostafa El Mezouari

Department of Parasitology-Mycology, Military Hospital Avicenne, Marrakech, Morocco
Redouane Moutaj

Department of Parasitology-Mycology, Military Hospital Avicenne, Marrakech, Morocco

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APA Style

Fatima Babokh, Zineb Nassiri, El Mostafa El Mezouari, Redouane Moutaj. (2021). Onychomycosis in the Military Hospital of Marrakesh: A Five-year Experience. American Journal of Laboratory Medicine, 6(4), 66-69. https://doi.org/10.11648/j.ajlm.20210604.13

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ACS Style

Fatima Babokh; Zineb Nassiri; El Mostafa El Mezouari; Redouane Moutaj. Onychomycosis in the Military Hospital of Marrakesh: A Five-year Experience. Am. J. Lab. Med. 2021, 6(4), 66-69. doi: 10.11648/j.ajlm.20210604.13

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AMA Style

Fatima Babokh, Zineb Nassiri, El Mostafa El Mezouari, Redouane Moutaj. Onychomycosis in the Military Hospital of Marrakesh: A Five-year Experience. Am J Lab Med. 2021;6(4):66-69. doi: 10.11648/j.ajlm.20210604.13

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@article{10.11648/j.ajlm.20210604.13,
  author = {Fatima Babokh and Zineb Nassiri and El Mostafa El Mezouari and Redouane Moutaj},
  title = {Onychomycosis in the Military Hospital of Marrakesh: A Five-year Experience},
  journal = {American Journal of Laboratory Medicine},
  volume = {6},
  number = {4},
  pages = {66-69},
  doi = {10.11648/j.ajlm.20210604.13},
  url = {https://doi.org/10.11648/j.ajlm.20210604.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajlm.20210604.13},
  abstract = {Onychomycosis is a nail fungal infection caused by dermatophytes, becoming one of the most frequent reasons for consultation in mycological dermatology in Morocco. The purpose of this work is to describe the epidemiology of onychomycosis and to specify the most frequently isolated fungal agents in the Avicenna Military Hospital of Marrakesh. This is a retrospective study that included 875 patients and took place in the Avicenna Military Hospital of Marrakesh over a period of 5 years. Direct examination on a slide with a coverslip after clarification with potassium hydroxide (KOH 30%), as well as culture on Sabouraud media supplemented with chloramphenicol and chloramphenicol with cycloheximide were systematically carried out. Incubation was carried out in 20-25°C for dermatophytes and 37°C for yeasts and molds. The tubes were regularly controlled (twice a week) for at least four weeks before giving negative results. Between January 2015 and July 2019, 875 patients were enrolled in this study. Sex ratio (M:F) was 1.06. The average age was 48 years. Toenails were affected in 683 cases (78%), fingernails in 192 cases (21.9%), and both fingernails and toenails in 120 cases (13.7%). Pachyonychia was present in 63% of the cases (551/875), subungual hyperkeratosis in 50.8% of the cases (444/875) and xanthonychia in 43% of them (376/875). 61% (625 / 875) of direct examinations were positive, of which 83% (522/625) were confirmed by positive culture. Dermatophytes were isolated in 86.8% of the cases (n=759), yeasts in 13% (n=113) and molds in 0.2% of the cases (n=2). Candida albicans was the only identified yeast in this series (13%), found mainly in fingernails. In addition, toenail onyxis was mainly caused by dermatophytes. Trichophyton rubrum and Trichophyton mentagrophytes var interdigital represented 80.8% and 6% of isolated dermatophytes, respectively. This work attests the contribution of mycological examination to the confirmation of fungal origin of onychopathies and the treatment orientation. Trichophyton rubrum was isolated in the majority of our cases.},
 year = {2021}
}

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