RESUMEN
BACKGROUND: A new genotype of the zoophilic fungal species Trichophyton (T.) mentagrophytes was recently described in two studies. It was isolated from three patients who had visited Southeast Asia and one patient who had visited Egypt. In contrast to these studies, we have observed a number of cases with the dimensions of an epidemic outbreak. PATIENTS AND METHODS: At the University Hospital Charité Berlin, 43 patients, mostly suffering from highly inflammatory, painful and persistent infections of the pubogenital region were observed between January 2016 and July 2017. Mycological examination was performed with fungal culture and sequencing of the ITS (internal transcribed spacer) region of the ribosomal DNA. Three additional genomic regions were spot-checked. RESULTS: In 37 of the cases, a new genotype of T. mentagrophytes (referred to here as T. mentagrophytes VII) was isolated as the etiological agent, and sequencing revealed identical sequences for all isolates. Most of the infected patients had no history of travel, and only two patients reported contact with animals. CONCLUSIONS: The new genotype clustered phylogenetically among the strains of the zoophilic species T. mentagrophytes with four different DNA markers. While human-to-human transmission of zoophilic dermatophytes is rare, transmission via sexual contact seemed to be quite effective here.
Asunto(s)
Enfermedades de Transmisión Sexual/microbiología , Tiña/microbiología , Trichophyton/aislamiento & purificación , Adulto , Animales , Antifúngicos/uso terapéutico , ADN de Hongos/análisis , Quimioterapia Combinada , Femenino , Enfermedades de los Genitales Femeninos/tratamiento farmacológico , Enfermedades de los Genitales Femeninos/microbiología , Enfermedades de los Genitales Masculinos/tratamiento farmacológico , Enfermedades de los Genitales Masculinos/microbiología , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Pomadas , Filogenia , Prurito/microbiología , Análisis de Secuencia de ADN , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/transmisión , Tiña/transmisión , Viaje , Resultado del Tratamiento , Adulto Joven , Zoonosis/tratamiento farmacológico , Zoonosis/microbiología , Zoonosis/transmisiónRESUMEN
Trichophytia infection, paraphrased cuddly toy mycosis, occurs primarily in prepubertal children, occasionally in infants and adults. The presented case shows the highly contagious infection of four family members with Trichophyton mentagrophytes. Effective treatment requires detailed diagnostic: identifying the dermatophyte, finding the infection source, treating the infection carriers. Tinea must be treated systemically and topically because of infectivity and ignitability. Systemic terbinafine or fluconazole treatment and topical fixed combination isoconazole nitrate/diflucortolone valerate are recommended.