Contagious fungal skin infections emerge
Public health officials are on high alert as new forms of ringworm and jock itch emerge. NYU Langone Health research reveals the severity and spread of these fungal infections.
This is the first documented case of sexually transmitted fungal infection in the United States.
A groundbreaking study from NYU Langone Health documented the first reported case of a sexually transmitted fungal infection in the United States. Trichophyton mentagrophytes type VII (TMVII) causes this infection, which can persist for months even with treatment. The case involves a man in his 30s who developed tinea on his penis, buttocks, and limbs after travelling to England, Greece, and California. Genetic testing confirmed the presence of TMVII, a strain that is increasingly being diagnosed in Europe, particularly among men who have sex with men.
Recognising the Symptoms of TMVII
Unlike typical ringworm, which presents as neat, circular rashes, TMVII infections can resemble eczema, leading to misdiagnosis and delayed treatment. Healthcare providers need to be vigilant and ask patients about rashes around the groyne and buttocks, especially those who are sexually active or have recently travelled abroad. Despite the difficulty of treating TMVII, it has shown some responsiveness to standard antifungal therapies like terbinafine.
The Challenge of Treating Trichophyton Indotineae
Another study by NYU Langone Health focuses on Trichophyton indotineae (T. indotineae), a fungal strain widespread in India and now reported globally. T. indotineae, which was first identified in the United States last year, causes itchy, contagious rashes similar to TMVII but often resists terbinafine treatment. Researchers collected data from 11 patients treated for ringworm in New York City hospitals, confirming T. indotineae as the cause. In many cases, standard terbinafine treatments failed to improve symptoms, attributed to genetic mutations in the fungal cells that prevented the drug from working effectively.
Alternative Treatments and Their Challenges
Three out of seven patients showed complete recovery and two experienced improvement when treated with itraconazole, another antifungal medication. However, itraconazole can cause side effects such as nausea and diarrhoea, complicating its long-term use. Physicians should recognize misleading signs of these fungal infections and consider each patient’s quality-of-life needs when selecting treatments.
Implications for Healthcare Providers
These studies provide crucial insights into the evolving landscape of fungal skin infections and their resistance to traditional treatments. Dermatologists and healthcare providers must stay informed about the latest developments and be prepared to identify and manage these infections. Collaboration with leading fungi experts and ongoing research is essential to track emerging cases and develop effective treatment strategies.
Conclusion
The reports from NYU Langone Health highlight the growing public health threat posed by hard-to-treat fungal skin infections. With the increasing incidence of TMVII and T. indotineae in the United States, healthcare providers must remain vigilant and proactive in diagnosing and treating these infections. As research continues, new insights and treatment options will be crucial in combating these resilient fungal strains.
Study Contributors and Funding
NYU Langone Health funded the studies. There are also contributions from Dr Avrom Caplan, Dr John Zampella, Michelle Sikora, Arianna Strome, Dr Christine Akoh, Dr Caitlin Otto, and Dr Sudha Chaturvedi.
