Dermatológia pre prax 3/2021

Comparison of diagnosis with results mycological microscopic and cultivation examination from children in area of Bratislava in 2008 – 2017

Introduction: Keratinophilic fungi cause typical manifestations, but also atypical manifestations, therefore etiological diagnosis is crucial for treatment and anti-epidemic measures. The aim of the study was to determine whether a clinical examination is sufficient to determine the correct diagnosis and compare .with results of mycological microscopic and culture examinations. Material and methods: We used the method of analysis of mycological examination results of the Mycological Laboratory of the Pediatric Dermatovenereology Departmemnt LF UK and NÚDCH in years 2008 - 2017. Microscopic examinations were performed in KOH preparations. The examinations were done under numbers without diagnosis. Culture examinations were performed on Sabouraud glucose-pepton agar on sloping soils in tubes with 9 to 24 inoculations. There were 2,470 materials examined for the presence of filamentous fungi. According to the diagnoses on the accompanying mycological checklists, we created Group 1 (1699), where the referring physicians reported a mycological diagnosis with the subgroups of T. pedum, T. corporis, T. unguium and Group 2 (771), where dispatch doctors reported a non-mycological diagnosis with subgroups of dermatitis atopica and other dermatoses. We determined % agreement between clinical diagnosis and outcome of microscopic and culture mycological examination for individual groups and subgroups. We determined % consent or differences in microscopic and culture mycological examinations. Results: In Group 1, clinical diagnosis and microscopic mycological examinations were confirmed in 26.6% and 23.01% in culture examinations. In Group 2, clinical diagnosis and microscopic mycological examinations were confirmed in 95.59% and 95.72% when cultured. The agreement of microscopic and culture mycological examination was found in Group 1 in 90.52% and in Group 2 in 97.28%. More frequent failure was found in the culture examinations (5.10%) as in the microscopic examinations (2.37%). Discusion: The need for mycological examination, simplicity of implementation, high sensitivity of microscopic mycological examination, the need for species determination, possible causes of differences in results from different workplaces are discussed. Conclusion: Microscopic mycological examination is neceserry for clinical practice. Dermatologists need species determination for recognition tinea as a occupational disease, but first of all it need public health to implement anti-epidemic measures.

Keywords: dermatofytes, microscopic mycological examination, culture mycological examination, children