Archives of Clinical Microbiology

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Superficial Fungal Infections: A 16 Years Study in ESRD Patients

Upma Narain and Arvind Gupta

Background: Mounting prevalence of end-stage renal disease is a major public health problem worldwide, resulting in millions of individuals affected. It is important to note that between 50% to 100% of such group have been found to have at least one or the other dermatological disorder. In the present study we have tried to analyze patients with end stage renal disease who had developed superficial fungal infections.

Methods and Findings: In between January 2000 to June 2016, analysis have been made on 2112 patients with end stage renal disease, who were undergoing haemodialysis at least thrice a week for a minimum of three months at our centre. Out of the above 2112 patients, 1500 suspected cases of superficial fungal infections we identified, 1040 cultures tested positive. The macroscopic examination of the scalp, skin and the nails revealed 0.2% Tinea capitis, 28.8% Pityriasis versicolor, 16.7% Tinea corporis, 5.3% Tinea mannum, 32.4% Onychomycosis, 13.5% Tinea cruris and 3.1% Tinea pedis. Culture examination highlighted 29.1% Trichyopyton rubrum, 22.9% Trychophyton mentagrophyte, 5.1% Trychophyton violaceum, 0.9% Trichophyton verrucosum, 0.1% Microsporum canis, 3.1% Epidermophyton flucossum, 3.1% Trychophyton tonsurans, 6.9% Scopulariopsis brevicaulis and 28.8% Malassezia. The predominant clinical abnormality observed was Onychomycosis and the prevalent fungal isolate was Trichophyton rubrum.

Conclusion: The current study illustrates that a notable number of patients with the end stage renal disease had a prevalence of superficial fungal infection; hence, a prompt recognition of skin lesion and identification of these superficial fungal infections alarm us to undertake early and judicious management in order to reduce the associated morbidity and thereby improve the quality of life in the said patients.