Authors

Siti N. Kholidah^a,b,c,*, Agnes S. Siswati^d, Tri Wibawa^c

Affiliations

^aDepartment of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Eyckman 38, Bandung, Indonesia^bCenter for Translational Biomarker Research, Universitas Padjadjaran, Eyckman 38, Bandung, Indonesia^cDepartment of Microbiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia^dDepartment of Dermatology, Venereology and Esthetica, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

Background

• Non-dermatophyte mold onychomycosis is rare, and Chaetomium spp. is an extremely rare cause, with fewer than 20 cases reported worldwide.

• Misdiagnosis often leads to treatment failure and relapse.

Methods

• Case report of the first documented Chaetomium onychomycosis in Indonesia, in a 29-year-old immunocompetent woman.

• Identified by direct microscopy and culture; antifungal susceptibility testing guided treatment.

Key Results

• The fungus was resistant to itraconazole and ketoconazole but sensitive to terbinafine and fluconazole.

• Three months of topical terbinafine, salicylic acid, and oral fluconazole achieved complete remission, with no recurrence at three months.

Discussion & Conclusion

• Rare mold pathogens should be considered in refractory nail infections.

• Antifungal susceptibility testing is critical for guiding combination therapy.

Related SDGs

SDG 3: Good Health and Well-Being – Improving diagnosis and treatment of rare infections

Journal Information

Journal: International Journal of Medical Microbiology

DOI: https://doi.org/10.1016/j.ijmm.2026.151728