The Sensitivity and Role of Mycology Laboratory in Management of Superficial Fungal Infections in Zliten Teaching Hospital

Introduction: The microscopic examination of skin, nails and hairs scrapings to detect the pathogenic fungi in patients with superficial fungal infections is very important step in the management, and this would be helpful to choose the most appropriate antifungals, and to expect their efficacy and needed duration of therapy.

Aims: This study was done to evaluate the sensitivity of KOH mounts as well as the sensitivity of fungal cultures on Sabouraudꞌs dextrose agar media in Zliten Teaching Hospital.

Methods: The data of eighty four patients with confirmed superficial fungal infections were enrolled in this retrospective study. The sites of samples intake from skin, nails or hairs were cleaned with ethanol 70%, and the scraped material was collected with use of sterile scalpel, and placed on a slide and covered with a drop of a 10% Potassium Hydroxide (KOH) solution, then a coverslip was applied, and after 10 minutes examined under microscope with power (x10) and (40). Part of collected scrapings was placed on Sabouraudꞌs dextrose agar media. The media were incubated in 26°C, and were examined twice weekly, over 4 weeks, to determine the specific etiologic fungus. The final results were made by interpretation of macroscopic and microscope features of grown fungal colonies.

Results: Males with confirmed fungal infection were 37 (represented 44%), while females were 47(represented 56%). The mean age of patients was 16.5 years (16.5±18). The most frequently diagnosed fungal infection was Tinea capitis, that its causative dermatophytes were isolated from 55 patients (consisted 65.5% of total number of patients).

The presence of superficial fungal infections was confirmed with direct microscopy of KOH mounts in 40 patients out of 54 patients, (represented 74% of performed KOH exams). The more frequently isolated dermatophytes were Trichophyton rubrum and Microsporum canis, which represented 14.29% and 13.9% respectively. While, no growth of pathogenic fungi was found in 25 patients, although, the presence of fungal skin infections was confirmed with examination of KOH preparations.

Conclusion: In Zliten Teaching Hospital, the sensitivity of direct microscopic examination of KOH mounts for fungal elements was 74%, and the sensitivity of cultural method with cultivation on Sabouraudꞌs dextrose agar media was 70%, this make use of both available methods would be very helpful as a diagnostic tools for patients with fungal infections.