Case ReportsImpact and Etiology of Periungual Toe Infections in Neutropenic PatientsVelez, Ana Paula MD*; Greene, John N. MD, FACP*; Vincent, Albert L. PhD†; Elko-Simms, Lucinda M. MD‡Author Information From the *H. Lee Moffitt Cancer Center and Research Institute, University of South Florida College of Medicine, Tampa, FL; †Division of Infectious Diseases and International Medicine, Department of Internal Medicine, College of Medicine, University of South Florida, Tampa, FL; and ‡Pharmacovigilance, Morrisville, NC. Correspondence to: John N. Greene, MD, FACP, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida College of Medicine, 12902 Magnolia Dr, FOB-3, Tampa, FL 33612-9497. E-mail: firstname.lastname@example.org. The authors have no funding or conflicts of interest to disclose. Infectious Diseases in Clinical Practice: November 2012 - Volume 20 - Issue 6 - p e31-e34 doi: 10.1097/IPC.0b013e3182506da4 Buy Metrics AbstractIn Brief Methods A chart review of the patients who had positive cultures of the nail for fungal infection from 1985 to June 2011 was conducted at Moffitt Cancer Center. Results Twenty-six patients with nail and periungual tissue cultures were included. The most common isolate was Fusarium, followed by Aspergillus. Lung imaging reported probable fungal pneumonia in 25% of the patients with Aspergillus onychomycosis and in 53% of the patients with Fusarium. All patients with Aspergillus infection survived to discharge, and 68% of the patients with Fusarium infection survived to discharge. Conclusions Our study revealed that the most common cause of paronychia with toe cellulitis in neutropenic patients is Fusarium. The key to ensure successful treatment of paronychia and toe cellulitis in neutropenic patients is early removal of the infected nail for diagnosis and therapy. Summary: Toenail trauma can be a cause of disseminated mold infection in neutropenic patients. Removing the toenail is the key to early diagnosis and possibly improves survival in patients with prolonged neutropenia. © 2012 Lippincott Williams & Wilkins, Inc.