Fusarium solani onychomycosis of the thumbnail coinfected with Pseudomonas aeruginosa: report of two cases

Fusarium species are non-dermatophytic moulds, which are commonly known soil saprophytes and important plant pathogens, and have been frequently reported to be aetiological agents of opportunistic infections in humans. The prevalence of onychomycosis caused by Fusarium species varies in the literature because of geographical differences in mould distribution and diagnostic methods. Onychomycosis caused by Fusarium species is considered rare in Korea, and only four cases have been described to date. Pseudomonas aeruginosa also can infect nails and cause green nail syndrome, and recent research has shown that fungal infection may potentiate the colonisation or growth of P. aeruginosa within a nail. Furthermore, such coinfection with P. aeruginosa can prevent the isolation of the fungus because of bacterial overgrowth in culture. The authors report the cases of two immunocompetent patients with F. solani onychomycosis coinfected with P. aeruginosa. Both presented with a greenish/yellowish discolouration and thickening of a thumbnail, and were treated with systemic ciprofloxacin in combination with itraconazole or terbinafine.