A comparison of direct microscopy and culture with periodic acid schiff staining in the diagnosis of onychomycosis

Authors : Vishwajith , Vishwajith , Ankitha Ravishankar, Ankitha Ravishankar, S A Lakshminarayana, S A Lakshminarayana, S Sangeetha, S Sangeetha

DOI : 10.18231/j.ijmr.2019.055

Volume : 6

Issue : 3

Year : 2019

Page No : 253-257

Introduction and Objectives: Onychomycosis, or fungal infection of the nail apparatus by dermatophytes
or nondermatophytes, is more than just a cosmetic problem. Dermatophytes are known to cause
90% of toenail and atleast 50% of fingernail onychomycosis. Our study offers insight into the
unique current epidemiological aspects of onychomycosis in our region, including the less known
nondermatophytemolds;. Since histopathology of nail clippings using Periodic Acid Schiff is clearly an
invaluable tool in diagnosing onychomycosis, we integrated and comparatively evaluated it with the tests
of routine mycology for the same.
Materials and Methods: Patients in Rajarajeswari Medical College and Hospital (a tertiary care hospital)
presenting with clinically apparent onychomycosis were included in this study. Each specimen of
subungual debris and nail clippings was divided into two portions- one for direct microscopy and the other
for culture. Nail clippings alone were used for PAS staining.
Results: The present study was carried out on 40 clinically suspected cases of onychomycosis in the
Department of Microbiology, Rajarajeshwari Medical College and Hospital over a period of one year. Out
of 40 samples, 14(35%) samples showed fungal elements in 20% KOH, in 12(30%) samples fungal culture
was positive and 19(47.5%) were PAS stain positive. Out of 12 isolates, 5(41.6%) were dermatophytes and
7(58.4%) were nondermatophytes.

Keywords: KOH, PAS, Dermatophytes, Nondermatophytes, Nail infection, Onychomycosis.


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