Nấm móng chân do Scopulariopsis brevicaulis giảm nhạy cảm với nhóm azole: Báo cáo một trường hợp lâm sàng hiếm gặp

Abstract

Scopulariopsis brevicaulis is a non-dermatophyte mould that can cause onychomycosis and is often difficult to be diagnosed and treated. We report a case of onychomycosis caused by S. brevicaulis affecting the right great big toenail of a 25-year-old female patient who presented to Hanoi Dermatology Hospital. S. brevicaulis was isolated from the affected nail specimen, producing characteristic brown, powdery colonies when cultured on Sabouraud dextrose agar, and species identification was confirmed by sequencing of the internal transcribed spacer (ITS) region. Microscopic examination under light microscopy revealed branched hyphae with chains of thick-walled, spherical conidia. In vitro antifungal susceptibility testing showed that the isolate exhibited high minimum inhibitory concentrations (MICs) to several azole antifungals. This case underscores the pathogenic potential and decreased susceptibility to azole antifungals of S. brevicaulis in onychomycosis, highlighting the importance of an integrated diagnostic approach - combining direct microscopy, culture, and molecular identification - to ensure accurate diagnosis and guide appropriate therapeutic management.