CLINICAL AND MICROBIAL PROFILE OF ONYCHOMYCOSIS IN ELDERLY PATIENTS
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Abstract
ABSTRACT
Background: Onychomycosis is one of common age-associated in elderly, primarily caused by dermatophytes, however, there are few clinical studies describing the clinical and microbial profile of Onychomycosis in elderly.
Aim: To describe the clinical and microbial profile of onychomycosis in elderly patients attending a specialized geriatric centre.
Methods: A total of 30 elderly cases of onychomycosis attending the Outpatient department of a Geriatric facility were enrolled in the study. Their demographic profile, exposure to risk factors and medical history was noted. Clinical examination was done and clinical pattern of disease was recognized. Nail/skin scrapings were obtained and were subjected to KOH mounting and culture assessment. Identification upto species level was performed. The data so obtained was tabulated and represented in numbers, percentages, mean and standard deviation.
Results: Age of patients ranged from 62 to 83 years (Mean age 70.70±6.21 years). Majority were males (53.3%), Nail plate discoloration (96.7%) and subungual hyperkeratosis (93.3%) were the most common clinical features. DLSO (66.7%) was most common pattern. All the patients had comorbidities. A total of 27 (90%) cases that were found to be KOH mount positive. On culture, all the KOH mount positive cases were identified to have only single pathogen. Dermatophytes (66.7%) were most common, followed by yeast/yeast-like isolates (18.5%) and non-dermatophytes (14.8%) respectively. Among dermatophytes, T. rubrum (n=14) was the most dominant whereas C. albicans (n=5) was most common yeast. Fusarium spp. (n=2) was the most common non-dermatophyte mold isolated.
Conclusion: The clinicopathological spectrum of onychomycosis was quite diverse. The study emphasized on the need for comprehensive diagnostic work-up of these patients in view of diverse etiology and clinical spectrum.
Key Words: Geriatric, Onychomycosis, KOH mount, Dermatophytes, Trichophyton rubrum
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