Candidal Onychomycosis in a Toddler

Abstract

Onychomycosis is uncommon in children, especially in early childhood. Candida species may rarely involve the nails in predisposed individuals such as children with finger-sucking habits, but an immunodeficiency should also be considered. We report an unusual case of onychomycosis caused by Candida albicans in a 24-month-old healthy girl without risk factors. We speculate that candidal onychomycosis may have been a secondary infection acquired during wound care by nurse hand cross-transmission.

Keywords

onychomycosis - Candida albicans - child

• References

• 1 Piraccini BM, Starace M. Nail disorders in infants and children. Curr Opin Pediatr 2014; 26 (4) 440-445
• 2 Ameen M, Lear JT, Madan V, Mohd Mustapa MF, Richardson M. British Association of Dermatologists' guidelines for the management of onychomycosis 2014. Br J Dermatol 2014; 171 (5) 937-958
• 3 Piraccini BM, Starace M, Bruni F. Onychomycosis in children. Expert Rev Dermatol 2012; 7 (6) 569-578 . DOI:10.1586/edm.12.58
• 4 Adams C, Athanasoula E, Lee W, Mahmudova N, Vlahovic TC. Environmental and genetic factors on the development of onychomycosis. J Fungi 2015; 1 (2) 211-216 . doi:10.3390/jof1020211
• 5 Jayatilake JA, Tilakaratne WM, Panagoda GJ. Candidal onychomycosis: a mini-review. Mycopathologia 2009; 168 (4) 165-173
• 6 Julapalli MR, Levy ML. Viral and fungal skin infections. In: Feigin RD, Cherry JD, Demmler-Harrison GJ, Kaplan SL, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 6th ed. Philadelphia: Saunders Elsevier; 2009: 794-810
• 7 Duhard É. Paronychia [in French]. Presse Med 2014; 43 (11) 1216-1222
• 8 Gupta AK, Paquet M, Simpson FC. Therapies for the treatment of onychomycosis. Clin Dermatol 2013; 31 (5) 544-554
• 9 Feldstein S, Totri C, Friedlander SF. Antifungal therapy for onychomycosis in children. Clin Dermatol 2015; 33 (3) 333-339
• 10 de Berker DAR, Bertrand R, Baran R. The nail in childhood and old age. In: Baran R, de Berker DAR, Holzberg M, Thomas L, eds. Baran & Dawber's Diseases of the Nails and their Management. 4th ed. Hoboken, NJ: John Wiley & Sons Ltd; 2012: 183-210
• 11 Tosti A, Piraccini BM, Lorenzi S, Iorizzo M. Treatment of nondermatophyte mold and Candida onychomycosis. Dermatol Clin 2003; 21 (3) 491-497 , vii
• 12 Rich P, Scher RK, Breneman D , et al. Pharmacokinetics of three doses of once-weekly fluconazole (150, 300, and 450 mg) in distal subungual onychomycosis of the toenail. J Am Acad Dermatol 1998; 38 (6 Pt 2) S103-S109
• 13 Brown SJ. Efficacy of fluconazole for the treatment of onychomycosis. Ann Pharmacother 2009; 43 (10) 1684-1691
• 14 Drake L, Babel D, Stewart DM , et al. Once-weekly fluconazole (150, 300, or 450 mg) in the treatment of distal subungual onychomycosis of the fingernail. J Am Acad Dermatol 1998; 38 (6 Pt 2) S87-S94
• 15 Scher RK, Tavakkol A, Sigurgeirsson B , et al. Onychomycosis: diagnosis and definition of cure. J Am Acad Dermatol 2007; 56 (6) 939-944
• 16 Perlroth J, Choi B, Spellberg B. Nosocomial fungal infections: epidemiology, diagnosis, and treatment. Med Mycol 2007; 45 (4) 321-346
• 17 Yildirim M, Sahin I, Kucukbayrak A , et al. Hand carriage of Candida species and risk factors in hospital personnel. Mycoses 2007; 50 (3) 189-192
• 18 Kampf G, Kramer A. Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs. Clin Microbiol Rev 2004; 17 (4) 863-893