PATIENT INFORMATION
JOHN DOE
Age: 44 years
Date of Birth: 01/31/61
Location/ID: PRIVATE OFFICE
PHYSICIAN
JACK SMITH, MD
1234 FIRST ST. #101
SOME CITY, CA 99999
SPECIMEN INFORMATION
Accession # WCS-06-99999 |
|
| Collected: | 01/03/2006 |
| Received: | 01/04/2006 |
| Reported: | 01/05/2006 |
ADDITIONAL INFORMATION FROM PHYSICIAN / COMMENTS
Left 4th digit nail fragments.
GROSS DESCRIPTION
Number of nail portions: Multiple.
Nail measurements: Single or smallest portion of nail 0.1 cm ranging to largest portion of nail 1.0 cm or Freehand Picture of specimens received.
MICROSCOPIC DESCRIPTION
Please note: Pertinent diagnoses are found in boxes
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
ONYCHOMYCOSIS
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.
