Men are more likely to get them than women, and the likelihood of developing one increases with age. Medical experts estimate that onychomycosis affects 1 in 10 people overall. That number jumps to 1 in 2 (50%) for people older than 70. A fungal nail infection usually isn’t painful unless it becomes severe. Some people who have fungal toenail infections also have a fungal skin infection on the foot, especially between the toes (commonly called “athlete’s foot”). Some people may be more likely than others to get a fungal nail infection, including older adults and people who have the following conditions:  A nail injury or nail surgery, diabetes, a weakened immune system, blood circulation problems, and athlete’s foot (ringworm on the foot). Dermatophytes (a type of mold) cause most toenail fungal infections.
Conventional laboratory diagnosis of onychomycosis routinely involves only direct microscopic examination (potassium hydroxide (KOH) preparation) of the clinical specimen to determine the presence of fungi; however, this does not identify genus, species, or the specific pathogen (disease-causing fungus), nor does it differentiate between yeasts and molds. Those tests often report a high rate of false negatives, resulting in inappropriate care or no treatment because a negative result does not rule out fungal infection in a high-risk host. Further identification of fungi grown in culture takes several weeks, with failure to isolate the pathogen in 30-50 percent of the cultures.
The advent of molecular technology for DNA testing has enabled the development of techniques like polymerase chain reaction (PCR) assay, a highly sensitive and specific test used for diagnosis of various microorganisms including fungal pathogens. PCR testing amplifies specific DNA sequences of dermatophyte fungus and is notably faster than traditional testing procedures (24 hours rather than days or weeks), leading to a significant reduction in time used to establish a diagnosis and initiate treatment.
Raazi Clinical Laboratory uses a quantitative polymerase chain reaction (qPCR or Real-Time PCR) for fungal nail infections. The method targets specific species to accurately detect pathogens and can do so within hours of receiving samples.