PATIENT INFORMATION

JACK SMITH

Age: 35 years
Date of Birth: 06/08/73

Location/ID: PRIVATE OFFICE

PHYSICIAN

JOHN SMITH, D.P.M.

1234 FIRST STREET
SOME CITY, CA 98765

SPECIMEN INFORMATION

Accession # WCS-09-99999
Collected:	03/26/2009
Received:	03/27/2009
Reported:	03/30/2009

SPECIMEN SITE / COMMENTS

TOENAILS RIGHT FOOT R/O MYCOSIS

GROSS DESCRIPTION

Number of nail portions: Multiple.
Nail measurements: Single or smallest portion of nail 0.1 cm. ranging to largest portion of nail 0.9 cm. or freehand picture of specimens received.

MICROSCOPIC DESCRIPTION

Please note: Pertinent diagnoses are found in Red

All specimens given softening procedure and stained with PAS stain, unless specified. Quantities noted from scattered rare 1+ to heavy-mycetoma 4+

Typical Fungal Mycelia Seen: 1+, 2+, 3+, 4+, Not seen

Fungi appear to be etiologic: Yes No

Spore forms present: Yes No

Bacteria, not fungi, appear etiologic: Yes No

Degenerative changes: Yes No

PAS CONTROL STAIN WORKING

FINAL DIAGNOSIS

TOENAIL BIOPSY: ONYCHOMYCOSIS, DIAGNOSTIC OF TRICHOPHYTON GENUS. ICD-9 #110.1

The presence of fungal hyphae in this specimen is consistent with Trichophyton Rubrum or Trichophyton Mentagrophytes. These latter are organisms commonly isolated from podiatric specimens. Nails infected with these organisms usually present as distal subungual infections. Toenails are frequently involved more than fingernails. These organisms also produce a chronic type of tinea pedis. Infections involving the interdigital areas can produce erythema, fissuring, and may extend into other portions of the foot. These organisms, because of their affinity for skin, can be susceptible to topical agents such as: Econazole, Oxiconazole, terbinafine, triacetin, and Undecylenic acid. Other agents have been approved by the FDA for oral therapy, including Itraconazole. Other causes of dystrophic or degenerative nail disorders include trauma, psoriasis, lichen planus, and eczema.

John Compagno M.D.,Medical Director
Original Report Reviewed and Verified

712 Alfred Nobel Drive . Hercules, CA 94547 . toll free 800.794.9737 . fax 510.662.5240 . www.wcpl.com . John Compagno, M.D., Medical Director

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