CASE REPORT Onychomycosis Associated with Superficial Skin Infection Due to Aspergillus sydowii in an Immunocompromised Patient Parismita Borgohain . Purnima Barua . Pranjal Jyoti Dutta . Dipika Shaw . Shivaprakash M. Rudramurthy Received: 26 December 2018 / Accepted: 30 August 2019 Ó Springer Nature B.V. 2019 Abstract Opportunistic fungal infections of the skin and nail are frequently encountered in human. Recent years have shown increased incidence of fungal infections especially in immunocompromised patients. Onychomycosis in HIV-infected patients is reported to occur in 15–40%, four times more than in the general population. Here, we report a case of fingernail proximal subungual onychomycosis with associated skin infection caused by an opportunistic mold, Aspergillus sydowii, in a HIV positive individ- ual. Isolation of A. sydowii from nail and skin of an immunocompromised person needs accurate identifi- cation for successful treatment. Keywords Onychomycosis Á Proximal subungual onychomycosis Á Aspergillus spp. Á Immunocompromised patient Introduction Superficial skin infection and onychomycosis are frequently encountered fungal infection in human. In clinical practice, fingernail infection constitutes 20–40% of all nail diseases [32]. It is characterized by discoloration, thickening, roughening and separa- tion of nail plate from the nail bed [35]. Based on clinical appearance, onychomycosis is classified into distal and lateral subungual onychomycosis (DLSO), proximal subungual onychomycosis (PSO), total dys- trophic onychomycosis (TDO), white superficial ony- chomycosis (WSO), candidal onychomycosis (CO), endonyx onychomycosis [15, 39, 40, 55]. PSO is relatively rare compared to the other types of onychomycosis, and DLSO is the most common type, occurring in approximately 90% of cases [23, 43]. Several fungi have been implicated, including der- matophytes, yeasts and non-dermatophyte molds (NDM). NDM’s are the heterogeneous groups of organisms which may cause skin infection and ony- chomycosis [5]. NDM’s are considered as secondary invader of nail plate or skin; hence, they are generally ignored when isolated from these samples [1]. World- wide, NDM’s have been reported as causative agents of onychomycosis (2–12%). Factors attributed to this disease include frequent environmental changes, occupational practices and personal hygiene [33]. Aspergillus spp. are considered as emerging NDM causing these infections. Commonly reported Asper- gillus spp. causing onychomycosis are A. niger [3, 33], Handling Editor: Jose ´ F. Cano-Lira. P. Borgohain Á P. Barua (&) Department of Microbiology, Jorhat Medical College, Jorhat, Assam 785001, India e-mail: drpurnimabarua@gmail.com P. J. Dutta Department of Dermatology, Jorhat Medical College, Jorhat, Assam 785001, India D. Shaw Á S. M. Rudramurthy Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India 123 Mycopathologia https://doi.org/10.1007/s11046-019-00383-2