Etiological Diversity and Enhanced Diagnostic Accuracy in Cutaneous Fungal Infections: Insights from a Tertiary Care Hospital Laboratory

Background: Cutaneous mycoses is a public health problem globally with significant rates in developing countries. These infections are predominantly caused by dermatophytes and non-dermatophyte fungi, with distinct clinical manifestations, epidemiological patterns, diagnostic intricacies, and treatment modalities. Objective: The study aimed to determine the spectrum of fungal agents causing cutaneous infections in our region and adoption of comprehensive diagnostic approach for accurate identification of the causative agents of cutaneous fungal infections. Methods: This observational study was conducted on 145 cutaneous samples received in Mycology laboratory of Mahatma Gandhi medical college and hospital from patients clinically suspected of dermatophytosis in the duration of July 2023 to December 2023. The samples were processed for microscopy using potassium hydroxide (KOH) mount and fungal culture on Sabouraud’s dextrose agar as per standard protocol. Fungal isolates were identified by studying colony morphology and microscopic characteristics. Results: One hundred forty-five samples consisting of 116 skin and 29 nails were studied. Male to female ratio was found to be 2.1:1. Adults from age group of 21–40 years were most commonly affected. Amongst 145 clinical samples, 111 (76.5%) were found to be positive microbiologically. Out of 111 positive specimen, culture positivity was 57.9% (84/111). Out of 84 culture isolates 59 (70.2%) were dermatophytes amongst which Trichopyton spp (45/59; 76.2%) were most common isolates. Non-dermatophytic fungi were isolated in 25 (29.8%) samples with Aspergillus spp. (17/25; 68%) being most common. Conclusion: Amongst dermatophytes Trichopyton spp. remains the most common pathogen in our region. The emerging recovery of Aspergillus spp. amongst non-dermatophytic fungi in our study warrants continuous epidemiological studies to be aware of the changing trends in terms of public health significance. The alignment of clinical diagnosis along with comprehensive laboratory diagnosis is pivotal for accurate diagnosis, considering the significant costs and extended duration associated with fungal therapy.