[Bilateral proximal cellulitis and onychomycosis in both big toes due to Fusarium solani].
We report a case of proximal fold cellulitis in both big toes, associated with a bilateral proximal onychomycosis and an intertrigo of the fourth space due to Fusarium solani. The infection occurred in an immunocompetent man with diabetes mellitus type II. Apparently, the infection was acquired in a tropical country and once the patient was in Spain the infection progressed causing nail detachment (onychomadesis). Seven months later a relapse that affected the left toenail occurred. The patient was treated topically with chemical toenail avulsion contained 40% urea associated with bifonazole followed by ciclopirox-olamine nail lacquer for 12 months. Complete cure without relapse was observed after 10 years of follow-up. In vitro antifungal susceptibility study demonstrated that two of the recovered isolates were both resistant to itraconazole and voriconazole.
Torres-Rodríguez
Josep M
JM
URMIM (Unidad de Investigación de Enfermedades Infecciosas y Micología), IMIM, Facultad de Medicina, Universitat Autònoma de Barcelona, c/ Dr. Aiguader, 80, 08003 Barcelona, Spain. jmtorres@imim.es
Sellart-Altisent
Maite
M
D000935:Antifungal Agents / Q000627:therapeutic use; D002481:Cellulitis / Q000188:drug therapy / Q000382:microbiology*; D000077768:Ciclopirox; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004198:Disease Susceptibility; D026141:Drug Resistance, Multiple, Fungal; D005533:Foot Dermatoses / Q000188:drug therapy / Q000382:microbiology*; D005670:Fusarium / Q000187:drug effects / Q000302:isolation & purification*; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D007121:Immunocompetence; D017964:Itraconazole / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D009073:Mozambique; D014009:Onychomycosis / Q000188:drug therapy / Q000382:microbiology*; D011728:Pyridones / Q000627:therapeutic use; D011743:Pyrimidines / Q000494:pharmacology; D012008:Recurrence; D014034:Toes / Q000382:microbiology*; D014195:Travel; D014230:Triazoles / Q000494:pharmacology; D014508:Urea / Q000627:therapeutic use; D065819:Voriconazole
D000935:Antifungal Agents; D007093:Imidazoles; D011728:Pyridones; D011743:Pyrimidines; D014230:Triazoles; D000077768:Ciclopirox; D017964:Itraconazole; D014508:Urea; D065819:Voriconazole; C036596:bifonazole