Microbial Causes of Paronychia

Background and Objectives: Paronychia is inflammation of the skin that surrounds a fingernail or toenail. It may be acute or chronic and is most commonly caused by infection with either bacteria or fungi. Methods: this paper will look for the possible bacteria and/or fungi that cause Paronychia; 112 Patients with paronychia were subjected to questionnaire; cultures were done for swabs from pus or discharge, and the cultivated microorganisms were further identified by biochemical methods. Control group, age and sex matched with patient group, subjected to the same questionnaire. Nasal swabs were taken from both groups for bacterial culture and identification. Results: staphylococcus aureus, candida albicans, klebseilla, and streptococcus pyogens are the only microorganisms identified, of which staphylococcus aureus is the most frequent one. There is a significant association between Staphylococcal nasal carries and paronychia, though all other parameters including age, sex, occupation, residency, marital status, and exposure to wetness, and family history showed a non-significant association as predisposing factors. Some of infections were unilateral, while others were bilateral. The infection might involve only one finger or toe, or it might involve more than one location. There is a significant association between klebseilla infection with chronicity and disfigurement of nail. Conclusions: factors including repeated exposure to wetness, occupation, history of local trauma, and family history of paronychia are not significant risk factors in etiology of paronychia, while persons who are nasal carriers for Staphylococcus aureus might represent a risk factor for paronychia. Staphylococcus aureus is the most common causative agent of paronychia, though other microorganisms might be implicated as causative agents. Infections due to klebsiella species tend to be chronic and complicated by disfigurement of nails. There is surprisingly no children involvement by paronychia which should further studied.