| COMPARISON OF DIFFERENT LABORATORY METHODS IN THE DIAGNOSIS OF ONYCHOMYCOSIS”.
Raziuddin Ahmed*, Saleem Ahmed Kharal**, Muhammad Asif Durrani**, Khurram J Siddiqui***, Wajid Khurshid**, Atta Muhammad****, Fakharuddin**, Sheikh Sajjad Ahmed*.
ABSTRACT
Objective:
Comparison of potassium hydroxide mount and mycological culture
with histopathologic examination using periodic acid-schiff staining
of the nail clippings in the diagnosis of onychomycosis
Hypothesis PAS (Periodic acid-Schiff ) staining is more effective
than KOH mount and fungal culture in the diagnosis of Onychomycosis.
Study Design:
Cross-sectional, comparative study.
Setting:
Study was carried out from October 2009 to May 2010, on one hundred
patients in the Department of Microbiology, Basic Medical Sciences
Institute (BMSI), Jinnah Postgraduate Medical Centre (JPMC), who
were clinically diagnosed as a case of Onychomycosis with the collaboration
of Dermatology department (JPMC) and Pathology Department, BMSI,
JPMC.
Method:
Specimen were taken from the department of dermatology, JPMC and
processed for the diagnosis by potassium hydroxide mount and mycological
culture in the department of Microbiology, BMSI, while histopathological
examination using Periodic acid-Schiff stain were performed in Pathology
department, BMSI. Potassium hydroxide mounts was microscopically
evaluated for the presence of thread-like branching structures (hyphae)
or beaded spherical structures (spores). If present, it was considered
as a positive test. Mycological culture was done using Sabouraud’s
dextrose agar at 25ºC and at 37ºC. Observation for growth
was done periodically for 4 weeks; if growth was present then the
pathogen was identified by cultural characteristics and microscopy.
PAS staining was done in Pathology department, BMSI. Presences of
intensely stained reddish dots or threadlike structures in between
the cells of the nail plate were considered to be a positive result.
Result:
KOH mount showed fungal element in fifty nine specimens while in
forty patients the culture was positive. Histopathological examination
using Periodic acid-Schiff stain was positive in seventy seven specimens.
Conclusion:
PAS stain was more effective than KOH mount and fungal culture.
Key word:
Onychomycosis, KOH mount, Fungal culture, PAS stain
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