Utilidad del exámen directo y estudio Histopatológico de Lámina Ungueal, en relación al Cultivo Micológico en el Diagnóstico de Onicomicosis. área de consulta externa del Hospital "Luis Vernaza" en el Perirodo: Octubre del 2009 a Septiembre del 2010

Abstract

Objective: To determine the diagnostic potential of direct examination and histopathological study of nail plate relative to the mycological culture in the diagnosis of onychomycosis. Methods: Observational, transversal, which involved 108 patients who attended the outpatient Vernaza Luis Hospital in the period October 2009 to September 2010 with X clinical findings of onychomycosis, which were conducted direct examination, mycological culture and histopathological examination of the plates affected nail. Statistical analysis: Representation of the results through statistical tables. Results: The predominant location was the foot nail lesions (69.44%), with primary involvement of the first toe (97.5%). The type of presentation was distal and lateral shape with a 53.57% in 73.75% hands and feet. Direct examination of nail plates showed positivity in 49.07% with a sensitivity to the mycological culture 62.5%, a specificity of 77.77%, positive predictive value of 84, 91% and a negative predictive value of 50 , 91%. The mycological culture showed positivity of 67.59%, with prevalence of infection caused by yeast (89.04%), followed by dermatophytes (9.59%) and non-dermatophyte molds (1.37%) in the yeast infection, there was a preponderance of the genus Candida with 75.38%, followed by the genus Trichosporon which accounted for 24.62% of cases. Within the genus Candida albicans species originated 55.38% of cases, followed by the species parasilopsis with 12, 31%. Of dermatophytes were isolated only 6 of the species Trichophyton spp and one case of rubrum, which corresponded to a lesion in the hands nail. In the group of non-dermatophyte molds isolated a single case caused by Fusarium, which also corresponded to nail dystrophy of the hand.