Tinea corporis intrafamilial infection in pets due to Microsporum canis.

Microsporum canis, one of the most widespread dermatophytes worldwide, is a zoonotic microorganism that transmits infection from reservoirs such as cats and dogs to humans. This microorganism is associated with Tinea corporis and other clinical manifestations; however, few studies have used genetic surveillance to determine and characterize the process of zoonotic transmission. In this study, we show a clear example of zoonotic transmission from a cat to an intrafamilial environment, where it caused Tinea corporis by infection with M. canis. Molecular characterization using the b-tubulin gene and Random Amplified Polymorphic DNA analysis made it possible to determine that the six isolates of M. canis obtained in this study belonged to the same genetic variant or clone responsible for reservoir-reservoir or reservoir-human transmission.

Discovery of New Trichophyton Members, T. persicum and T. spiraliforme spp. nov., as a Cause of Highly Inflammatory Tinea Cases in Iran and Czechia.

Pathogens from the Trichophyton benhamiae complex are one of the most important causes of animal mycoses with significant zoonotic potential. In light of the recently revised taxonomy of this complex, we retrospectively identified 38 Trichophyton isolates that could not be resolved into any of the existing species. These strains were isolated from Iranian and Czech patients during molecular epidemiological surveys on dermatophytosis and were predominantly associated with highly inflammatory tinea corporis cases, suggesting possible zoonotic etiology. Subsequent phylogenetic (4 markers), population genetic (10 markers), and phenotypic analyses supported recognition of two novel species. The first species, Trichophyton persicum sp. nov., was identified in 36 cases of human dermatophytosis and one case of feline dermatophytosis, mainly in Southern and Western Iran. The second species, Trichophyton spiraliforme sp. nov., is only known from a single case of tinea corporis in a Czech patient who probably contracted the infection from a dog. Although the zoonotic sources of infections summarized in this study are very likely, little is known about the host spectrum of these pathogens. Awareness of these new pathogens among clinicians should refine our knowledge about their poorly explored geographic distribution. IMPORTANCE In this study, we describe two novel agents of dermatophytosis and summarize the clinical manifestation of infections. These new pathogens were discovered thanks to long-term molecular epidemiological studies conducted in Czechia and Iran. Zoonotic origins of the human infections are highly probable, but the animal hosts of these pathogens are poorly known. Further research is needed to refine our knowledge about these new dermatophytes.

The unprecedented epidemic-like scenario of dermatophytosis in India: II. Diagnostic methods and taxonomical aspects.

Trichophyton (T.) mentagrophytes now accounts for an overwhelming majority of clinical cases in India, a new "Indian genotype" (T. mentagrophytes ITS genotype VIII) having been isolated from skin samples obtained from cases across a wide geographical distribution in this country. The conventional diagnostic methods, like fungal culture, are, however, inadequate for diagnosing this agent. Thus, molecular methods of diagnosis are necessary for proper characterization of the causative agent. The shift in the predominant agent of dermatophytosis from T. rubrum to T. mentagrophytes, within a relatively short span of time, is without historic parallel. The apparent ease of transmission of a zoophilic fungus among human hosts can also be explained by means of mycological phenomena, like anthropization.

Tinea capitis et barbae caused by Trichophyton tonsurans: A retrospective cohort study of an infection chain after shavings in barber shops.

BACKGROUND: Tinea capitis is a highly contagious infectious disease caused by dermatophytes. In Central Europe, it is mainly caused by zoophilic dermatophytes, as, for example Microsporum (M) canis or Trichophyton (T) mentagrophytes and increasingly by anthropophilic fungi. T tonsurans was commonly related to the Tinea gladiatorum, where transmission occurred between infected persons or via contaminated floors. OBJECTIVE: Reporting the transmission of this highly contagious dermatophyte for the first time via beard shaving and hairdressing in barber shops in Germany. PATIENTS AND METHODS: 18 young male patients developed tinea capitis and/or barbae shortly after shavings of the beard and/or hair in a barber shop. Native, cultural and molecular diagnostics as well as tissue biopsies and resistance tests were performed of skin and hair samples. RESULTS: In all samples, T tonsurans could be identified. The medical history and the clinical picture suggest a transmission through contaminated hairdressing tools. The patients were treated with terbinafine or itraconazole in combination with or exclusively with topical antimycotics. CONCLUSION: The transmission and a resulting increase in the incidence of infections with T tonsurans may be due to shavings with direct skin contact of insufficiently disinfected hairdressing tools. This path of infection has already been observed in Africa and is now being described for the first time in Germany. Knowledge of the pathogen and its transmission ways are essential to interrupt the chain of infection.

[Tinea corporis within recent tattoos]. / Dermatophytose sur des tatouages récents.

INTRODUCTION: Tattoos are occasionally associated with cutaneous infections. Diagnosis can be challenging as the clinical presentation of such infections may differ from those on plain skin. Herein we report an atypical form of tinea corporis restricted to two recent tattoos during healing, caused by environmental contamination. We reviewed the literature for all cases of fungal infection after tattooing. PATIENTS AND METHODS: A 27-year-old female patient was seen for ring-shaped, erosive, oozing, pruritic and rapidly extensive skin lesions as well as infiltrated papular lesions occurring on tattoos done 6 and 12 days earlier. Fungal analysis revealed Microsporum canis. History-taking indicated that the patient's cat had ringworm and that the patient's sister also had skin lesions consistent with tinea corporis. DISCUSSION: Tinea on tattoos is rarely reported. We found ten additional cases in the literature, as well as five cases of less common fungal infections. These could be explained by the skin break created by the needle during tattooing resulting in an impaired skin barrier, or by accidental self-inoculation (e.g. foot-tattoos). The hypothesis of local immune deficiency induced by tattoo inks strikes us as rather improbable. Unlike usual cases of infections (pyogenic bacteria, mycobacteria, viral hepatitis), fungal infections are not related to a lack of hygiene on the part of the tattooist, but rather to contamination during the healing phase. Their clinical presentation may be atypical, resulting in diagnostic difficulties.

Epidemiological survey of 42 403 dermatophytosis cases examined at Nagasaki University Hospital from 1966 to 2015.

The causative species of a total of 42 403 dermatophytosis cases that occurred during 1966-2015 were surveyed. The most prevalent clinical type was tinea pedis, followed by tinea unguium, corporis, cruris, manus, faciei and capitis. The prevalence of tinea faciei and capitis has increased since the late 1990s and the late 2000s, respectively. The most prevalent dermatophyte species was Trichophyton rubrum, followed by Trichophyton mentagrophytes (the majority of the isolates were Trichophyton interdigitale in the latest nomenclature). These dermatophytes were detected in over 80% of the isolates identified in tinea pedis, unguium, cruris and manus cases. Recently, Microsporum canis and Trichophyton tonsurans have been increasingly identified. The frequency of M. canis isolated from tinea corporis, faciei and capitis cases started to rise in the early 1990s. T. tonsurans was first identified in Nagasaki in 2003. T. rubrum was the most commonly isolated pathogen in tinea faciei and corporis cases. However, the proportion of cases attributed to it has decreased since the early 1990s, whereas M. canis and T. tonsurans are being increasingly isolated since the early 2000s. In tinea capitis cases, the proportion of each pathogen isolated has changed dramatically. M. canis was first identified in the late 1970s, with an increasing prevalence up to the early 1990s. In contrast, the prevalence of T. tonsurans has increased since the early 2000s. In the 2010s, the most common fungus causing tinea capitis was T. tonsurans, followed by M. canis and T. rubrum.

Molecular epidemiology of Tinea gladiatorum in contact sports in northern Iran.

BACKGROUND: Tinea gladiatorum as the major health concern among combat athletes and the most common cause of a decrease in the quality of their sports activities. OBJECTIVES: This study aimed to determine the molecular epidemiology of tinea gladiatorum in contact sports in Mazandaran Province, Northern Iran. MATERIALS/METHODS: In total, 631 suspected athletes out of 4240 ones were screened for tinea gladiatorum in this cross-sectional study from May 2018 to February 2019. The infection was confirmed by direct microscopy and culture tests. The causative agents were identified by polymerase chain reaction-restriction fragment length polymorphism method on ITS rDNA region. The indoor environmental factors were evaluated in 81 sports halls in terms of temperature (°C), humidity (%), density (m2 /athletes) and the number of ventilators. RESULTS: Tinea gladiatorum was confirmed in 6.5% (278/4240) of the athletes. Tinea corporis was the most common type of tinea (192/278; 69.0%), and 175 cases (27.7%) had more than one type of tinea. Moreover, Trichophyton tonsurans (192/203; 94.5%) was the most aetiological agent in all athletes followed by Microsporum canis (6/203; 2.9%), Trichophyton rubrum (2/203; 0.9%) and Trichophyton interdigitale (1/203; 0.4%). There was no significant association between the prevalence of tinea gladiatorum and the indoor environmental factors. CONCLUSION: T. tonsurans is the most common agent of tinea gladiatorum in Northern Iran. Since no positive culture of dermatophyte was obtained from mats, it seems that skin-to-skin contact would be the most probable mode of transmission among wrestlers. Accordingly, periodical checkups should be considered by health care providers.

Trichophyton species and Microsporum gypseum infection and fomite carriage in cats from three animal shelters: a retrospective case series.

OBJECTIVES: The goal of this retrospective case series was to report on the clinical aspects of confirmed Trichophyton species and Microsporum gypseum infections in cats from three animal shelters. METHODS: This was an observational retrospective study. Fungal culture and treatment data from three animal shelters was retrospectively reviewed to identify cats with dermatophytosis caused by Trichophyton species or M gypseum. RESULTS: Among the three shelters only four cats were diagnosed with M gypseum dermatophytosis. With respect to Trichophyton species infections, there were six cases identified and treated in a 1 year period in one shelter, 13 cases over 13 years in the second shelter and 27 cases over 5 years in the third shelter. Four cases of M gypseum dermatophytosis were treated in the third shelter. Young cats were most commonly infected and the disease was most commonly diagnosed in the fall and winter months. Lesions were inflammatory and found predominantly on the head and neck. There was a rapid response to treatment in all cases; mean (n = 20) and median (n = 17) days to mycological cure were calculated from available data. Fungal culture data revealed fomite carriage without clinical evidence of infection for Trichophyton species (n = 43) cats and M gypseum (n = 37) cats. CONCLUSIONS AND RELEVANCE: There is a paucity of clinical information about non-Microsporum canis dermatophytosis in shelter cats. This study data shows that Trichophyton species and M gypseum infections do occur but are uncommon. Based upon the rapid response to conventional treatment, these infections do not represent a treatment challenge, as most cats reached mycological cure within 3 weeks.

Tinea corporis caused by Trichophyton equinum transmitted from asymptomatic dogs to two siblings.

Each year, millions of people worldwide are affected by superficial mycoses, which are frequently caused by dermatophytes having affinity to the scalp, nails, hair and the stratum corneum of the skin. The changing reservoirs of zoophilic dermatophytes, the numerous reports of animal carrier status, and the increasing number of pets make the diagnosis difficult, which is usually impossible based only on medical history. Herein we present a case report of tinea corporis caused by Trichophyton equinum in siblings who had no contact with horses. The routine laboratory diagnostic procedures for identification of isolates were based on phenotypic and genotypic characteristics, especially molecular techniques using rDNA internal transcribed spacer sequences. The results showed that both techniques proved to be insufficiently discriminatory to differentiate two closely related species, i.e. Trichophyton equinum and Trichophyton tonsurans. Introduction of a TEF1 sequence analysis to the diagnostic procedures revealed consistent differences between these two species and facilitated unambiguous identification. Interestingly, dogs that could leave the homestead freely were the source of the infection in children. In conclusion, Trichophyton equinum was considered in the past as a strict zoophilic dermatophyte associated with horses and rarely transmitted to humans. This study revealed that this species can have other reservoirs and live in the fur of asymptomatic animals.

In search of the source of dermatophytosis: Epidemiological analysis of Trichophyton verrucosum infection in llamas and the breeder (case report).

During the last few years, the number of cases of Trichophyton verrucosum isolation from humans suffering from mycoses has been constantly increasing, which is correlated with the presence of an increasing number of outdoor breeding farms. Farmers and their families as well as veterinarians and technicians involved in handling the animals are at a higher risk of infection. One of the most important aims of mycological diagnostics is epidemiological analysis. Typically, the history of the disease is not sufficient to indicate reliably and eliminate the outbreak of infection. PCR fingerprinting methods are a useful tool in this type of analysis, which is presented in this study. The main aim is to present diagnostic and epidemiological analyses of dermatophyte isolates from llamas and their breeder. In two llamas, round alopecia sites or ca. 2-cm excoriations covered with thickened scaling epidermis were noticed at the border of the head and neck with a distinct tendency towards hair loss. Tinea unguium was noticed in a nail of the breeder's right hand. Direct analysis of the material from the clinical lesions revealed the presence of arthrospores. The macro- and micromorphology of the isolates were homogeneous and characteristic for T. verrucosum. The identification analysis based on the ITS sequences confirmed the previous morphological diagnostic examination. The MP-PCR and MSP-PCR analysis indicated high invariability of the genomes of the strains isolated from the human and animals. The epidemiological research has indicated an identical source of dermatophyte infection in the breeder and the lamas. To sum up, the number of pets and farm animals is increasing and dermatologists should always be informed about possible dermatophyte transmission sources. The possibility of transmission of zoophilic dermatophytes from humans to animals is a suggestion for further analysis; therefore, this type of transmission should be considered in dermatological studies.

Trichophyton violaceum: An Emerging Pathogen in Southern Switzerland.

BACKGROUND: Trichophyton violaceumis an anthropophilic dermatophyte, endemic in Africa and recently an emerging pathogen in Europe. OBJECTIVE: To perform a retrospective analysis of dermatophytoses due to T. violaceum between 2007 and 2018, in order to evaluate epidemiological trends in Southern Switzerland (Ticino). METHODS: We reviewed all medical records of patients affected by dermatophytosis due to T. violaceum between January 2007 and December 2018 in Bellinzona (Ticino, Switzerland). RESULTS: Dermatophytoses due to T. violaceumwas diagnosed in 44 patients, 33 of which were in the last 4 years. The most affected sex was female (25/44) and the most frequent diagnosis was tinea capitis (30/44). The majority of tinea capitis patients were children younger than 13 years of age (27/30). The main source of contagion were people from endemic areas, especially from Eritrea. CONCLUSION: In Southern Switzerland T. violaceumhas been rarely diagnosed before 2014. Its increased occurrence seems linked to increased migratory flows from Eritrea. Since it is responsible mainly for tinea capitis, with most of the time no clearly defined alopecia patches, it is important to consider it as a possible diagnosis when facing scalp scaling. Tinea capitis due to T. violaceum is a benign affection, but if left untreated it can spread epidemically, especially among children in schools and kindergartens. Mycological examination is then required, not only for a correct diagnosis and epidemiological data, but also for planning the appropriate treatment.

An Epidemiological Study of Feline and Canine Dermatophytoses in Japan.

In a 2012-2014 epidemiological study of feline and canine dermatophytoses in Japan, we investigated the prevalence of fungi among 296 cats and 170 dogs treated at a veterinary clinic and 51 cats and dogs at an animal shelter at Fukui City in Japan. Microsporum canis was isolated from only one cat out of the 517 animals. Also, from 2012 to 2017, we analyzed isolates from 76 cats and 15 dogs with dermatophytoses at 14 veterinary clinics across 10 prefectures in Honshu and Shikoku. M. canis was the cause for 85 of the cases and Microsporum gypseum for the other six. M. canis infection routes in cats are thought to include stray cats as well as breeding facilities and pet shops, whereas for dogs, only breeding facilities and pet shops. Tinea was found in 18.7% (14/75) of the owners of these animals. We showed that microsatellite genotyping is useful for molecular epidemiological investigations such as determination of infection routes of M. canis.

Trichophyton mentagrophytes - a new genotype of zoophilic dermatophyte causes sexually transmitted infections.

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.

Tinea Corporis Due to Trichophyton erinacei Probably Transmitted from a Hedgehog.

A 26-year-old female homemaker presented with an approximately 2-month history of an erythematous lesion with agminated seropapules in the right popliteal fossa associated with scales and crusts. The lesion was initially treated as contact dermatitis, but there was no improvement. KOH examination revealed filamentous fungi. The fungal culture was positive, and the morphological characteristics were identical to those of Trichophyton mentagrophytes complex. The fungus was identified as T. erinacei based on genetic analysis. This is the second case report of human tinea corporis due to this fungus in Japan.

Molecular Epidemiological Analysis of the Spreading Conditions of Trichophyton in Long-Term Care Facilities in Japan.

Tinea pedis and tinea unguium are common infectious diseases, and many elderly people are reported to contract these infections. In this study, to investigate whether strains of the same origin are spreading inside a long-term care facility, we analyzed Trichophyton rubrum and Trichophyton mentagrophytes, isolated from the residents and staff at the facilities located in the Kanto area, using a genomic analytical method targeting tandem repeat regions in the nontranscribed spacer (NTS) region of ribosomal DNA. Five NTS types were confirmed in T. rubrum. T. rubrum of various types (types 1 to 5) was detected at each facility, but there was no isolate specific to one facility only. Eight NTS types of T. mentagrophytes were detected, and T. mentagrophytes that carried an NTS type that was confirmed at one facility only (types C4II, F4II, and D4II) was isolated. These T. mentagrophytes sequence types were isolated from several subjects residing at the same facility. This study proved that a T. mentagrophytes strain of the same type had spread in long-term care facilities. We believe in the importance of cleaning at a long-term care facility as a countermeasure to the spread of Trichophyton species.

[Trichophyton mentagrophytes-from snow leopard to man : A molecular approach for uncovering the chain of infection]. / Trichophyton mentagrophytes ­ vom Schneeleoparden zum Menschen : Ein molekularer Ansatz zur Aufdeckung der Infektionskette.

Sources of infection for Trichophyton (T.) mentagrophytes-a zoophilic dermatophyte-comprise pet rodents (guinea pigs, mice, rabbits) and sometimes cats. Human infections due to dermatophytes after contact with zoo animals, however, are extreme rare. Four zoo keepers from Basel Zoo were diagnosed to suffer from tinea manus and tinea corporis due to T. mentagrophytes. The 22-year-old daughter of one zoo keeper was also infected with tinea corporis after having worked in the snow leopard section for one day. The strain of the index patient was confirmed by a direct uniplex-PCR-EIA and sequence analysis of the ribosomal internal transcribed spacer (ITS) region (18S rRNA, ITS1, 5.8S rRNA, ITS2, 28S rRNA) as T. mentagrophytes. Three young snow leopards from Basel Zoo were identified as the origin of the fungal skin infection. The transmission occurred due to direct contact of the zoo keepers with the young snow leopards when removing hedgehog ticks (Ixodes hexagonus). Two adult snow leopards had developed focal alopecia of the facial region which was diagnosed as dermatomycoses due to T. mentagrophytes by the zoo veterinarians. By sequence analysis, both the strains from the animals and a single strain of the index patient showed 100% accordance proving transmission of T. mentagrophytes from animals to the zoo keepers. Molecular biological identification revealed a strong relationship to a strain of T. mentagrophytes from European mink (Mustela lutreola) from Finland. Treatment of patients was started using topical ointment with azole antifungals, and oral terbinafine 250 mg once daily for 4 weeks. Both adult snow leopards and the asymptomatic young animals were treated with oral itraconazole.