Comunicado IUSTI asociado a infecciones causadas por Trichophyton mentagrophytes
- 04 julio 2024
Comunicado
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ECDC has received reports of ongoing local transmission of severe dermatophyte infections among men who have sex with men (MSM) caused by Trichophyton mentagrophytes genotype VII (TMVII) which is contagious, can spread easily by skin-to-skin contact, and can cause severe pain and scarring if left untreated.
Researchers at an academic hospital in France published a case series of TMVII infections during 2021-2022 among MSM that involved 13 patients diagnosed at three large tertiary hospitals in Paris who had severe, inflammatory infections, substantial diagnostic delays, severe pain, and scarring. Seven were HIV-positive. One case report being infected in Germany. Cases have continued to emerge since the publication of the article and clinicians believe this is an emerging issue. Reports from a large clinic in Germany include about 30 cases since 2020 likely with sexual transmission between MSM but also heterosexual contacts. A lab specialized in diagnostics of dermatophytes reports 1-10 cases per year over the last 10 years.
Notification is not mandatory in either France or Germany so knowledge about the total number of cases and their characteristics is limited. The clinical course may frequently be serious and it is reported that patients may experience a long course of mis-diagnosis and -treatment due to lack of knowledge of this issue among clinicians.
A case of Trichophyton mentagrophytes was also very recently reported in New York City, in a young man who has sex with men, recently returning from a trip to the UK and Greece, where he had sex with multiple partners.
A call to the ECDC STI network has not yielded any more cases. ECDC has not issued a more general alert but would like informally to check with the wider IUSTI Europe membership if they are aware of similar presentations, and to make sure practitioners are aware of this emerging pathogen.
Note: TMVII is distinct from but closely related to Trichophyton indotineae (TMVIII), a different globally emerging fungus causing severe ringworm. Unlike T indotineae¸ TMVII does not appear to be resistant to terbinafine. Both fungi, however, are public health concerns.
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