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Scher and Daniel’s Nails pp 161–172Cite as

Onychomycosis: Laboratory Methods

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Abstract

Onychomycosis is caused by dermatophytes, and to a lesser extent by non-dermatophyte moulds (NDMs), and Candida spp. It is important to identify the causative agent of each case of onychomycosis in order to provide the proper management, which includes antifungal therapy, possible physical debridement, and expectant prognosis. This chapter provides guidelines for the proper collection of nail specimens for direct smear and culture. Additionally, various methods for performing direct examinations of clinical material are included, as well as descriptions of both conventional laboratory methods and molecular assays for identifying these fungal species. In cases of treatment failure, it is also important to have a means of determining an infecting organism’s susceptibility to available antifungals. Various susceptibility assays, including broth microdilution and agar diffusion, are compared. Finally, the importance of proper laboratory diagnosis of onychomycosis to the success of clinical trials of novel antifungals is discussed, with an emphasis on the role of negative microscopy in the definition of mycological cure.

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Author information

Authors and Affiliations

  1. Center for Medical Mycology, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, OH, USA

    Mahmoud Ghannoum & Nancy Isham

Authors
  1. Mahmoud Ghannoum
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  2. Nancy Isham
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Corresponding author

Correspondence to Mahmoud Ghannoum .

Editor information

Editors and Affiliations

  1. University of Pennsylvania, Philadelphia, PA, USA

    Adam I. Rubin

  2. Brown University, Providence, RI, USA

    Nathaniel J. Jellinek

  3. Department of Dermatology, University of Mississippi Medical Center, Jackson, MS, USA

    C. Ralph Daniel III

  4. Department of Dermatology, Weill Cornell Medical College, New York, NY, USA

    Richard K. Scher

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Ghannoum, M., Isham, N. (2018). Onychomycosis: Laboratory Methods. In: Rubin, A.I., Jellinek, N.J., Daniel, C.R., Scher, R.K. (eds) Scher and Daniel’s Nails. Springer, Cham. https://doi.org/10.1007/978-3-319-65649-6_10

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  • DOI: https://doi.org/10.1007/978-3-319-65649-6_10

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-65647-2

  • Online ISBN: 978-3-319-65649-6

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