Onychomycosis in KwaZulu-Natal: Clinical spectrum, risk factors and fungal susceptibility.

StudyJournal of the colleges of medicine of South Africa· 2026

Onychomycosis in KwaZulu-Natal: Clinical spectrum, risk factors and fungal susceptibility.

Jaya Jhoomuck, Yesholata Mahabeer, Antoinette Chateau

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Hair & NailStudyTreatment

Candida species caused two-thirds of onychomycosis cases in retrospective analysis.

Onychomycosis in KwaZulu-Natal: Clinical spectrum, risk factors and fungal susceptibility.

Jaya Jhoomuck … Antoinette Chateau

Journal of the colleges of medicine of South Africa · 2026

Background

Although onychomycosis is common worldwide and often significantly impairs the quality of life of patients, local epidemiological and mycological data are lacking.

Methods

In the retrospective arm, positive fungal nail cultures from 2018 to 2024 were analysed.

n = 301 patients

Results

candida, not typical nail fungus, drove most infections, favor fluconazole

Candida species

66.7%

Moulds

13.6%

Trichophyton species

11.9%

More results

Candida species (40.4%), moulds and Trichophyton species (25.0% each) were most frequent in 52 patients with positive cultures.

All Candida species were susceptible to fluconazole.

Most patients had subungual hyperkeratinisation.

More results

Immunosuppression (other than human immunodeficiency virus [HIV] infection and diabetes mellitus) was the most common risk factor.

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Conclusion · 1 of 3

Candida species were the commonest cause of onychomycosis; therefore fluconazole is an appropriate treatment modality.

Conclusion · 2 of 3

However, revision of the existing essential drug list is recommended to include itraconazole or terbinafine for patients with confirmed infection with moulds or dermatophytes.

Conclusion · 3 of 3

CONTRIBUTION: This is the first detailed analysis of onychomycosis in KwaZulu-Natal and contributes to the limited body of data in South Africa. Our results may be used to inform therapeutic recommendations.

Onychomycosis in KwaZulu-Natal: Clinical spectrum, risk factors and fungal susceptibility.

Onychomycosis in KwaZulu-Natal: Clinical spectrum, risk factors and fungal susceptibility.

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