Cycloheximide-resistant Aspergillus candidus onychomycosis: an unusual case

Introduction: Onychomycosis is a chronic, superficial fungal infection that affects the nails and is most frequently caused by dermatophytes. Onychomycosis due to Aspergillus spp. (A.) is rare. A. flavus, A. niger, and A. fumigatus are the most implicated of these non-dermatophyte molds. A. candidus is a very unusual opportunistic pathogen of the nails. Only a few cases have been previously published internationally, but neither was cycloheximide-resistant. Case presentation: Here we report the first case of onychomycosis caused by cycloheximide-resistant A. candidus in a 63-year-old diabetic man. The diagnosis was made on the basis of a positive direct examination and pure cultures growing on Sabouraud's agar with chloramphenicol and cycloheximide on all inocula in three consecutive toenail samplings at one-week intervals. Conclusion: Such clinical cases are important to be presented by medical mycology teams in order to maintain vigilance regarding the epidemiological trends, which evolve constantly.