United States: Experts caution in two reports that drug-resistant fungal infections are spreading throughout the United States, leading to extremely contagious and difficult-to-treat instances of ringworm, also known as jock itch or athlete’s foot.
Concerning Spread
According to researchers, the two fungus that were reported are part of a group that can cause skin rashes on the feet, groin, limbs, and face.
Regretfully, the rashes may not resemble the tidy, regular circles typical of most ringworm types, according to researchers. They could go for months without receiving the right care and be mistaken for eczema.
New Cases
Following his return to New York City from a trip to England, Greece, and California, a man in his 30s reportedly had such a rash on his penis, buttocks, and limbs, according to a report published June 5 in the journal JAMA Dermatology
Trichophyton mentagrophytes type VII, a sexually transmitted form of ringworm, was identified as the source of the infection using genetic testing. The man admitted to the physicians that he had slept with several men while traveling, but none of them had complained of the same skin conditions.
Challenges in Treatment
Lead author Dr. Avrom Caplan, an assistant professor of dermatology at NYU Grossman School of Medicine in New York City, stated that “healthcare providers should be aware that Trichophyton mentagrophytes type VII is the latest in a group of severe skin infections to have now reached the United States.”
According to senior researcher Dr. John Zampella, an associate professor of dermatology at NYU Grossman, infections brought on by that fungus are hard to cure and can take months to go away.
Eleven men and women treated for ringworm in New York City hospitals in 2022 and 2023 were the subject of the second report published in JAMA Dermatology.
Their infection involved Tichophyton indotineae , a fungal infection widespread in India that was first confirmed in the United States last year.
For a duration of 14 to 42 days, seven patients were administered conventional dosages of terbinafine, a brand name known as Lamasil, yet their rashes did not improve.
Researchers used DNA analysis to identify multiple genetic code differences in the fungus that inhibit terbinafine from attaching itself to fungal cells and puncturing holes in their outermost membranes. This could be the reason the medication was unable to combat the infection.
Research and Monitoring
Researchers reported that of seven patients treated with itraconazole, another antifungal, three fully recovered and two improved.
Regretfully, Caplan said that itraconazole can produce nausea, diarrhea, and other side effects that make it difficult to use over an extended period of time. It can also react with many other medications.
“These results provide fresh understanding of how some of the fungal skin infections that are migrating from South Asia can avoid our standard treatments,” added Caplan. “Physicians will need to make sure their treatment meets each patient’s quality-of-life needs, in addition to learning to recognize their misleading signs.”
Prominent specialists in the field of fungi both domestically and abroad are striving to broaden their research endeavors and monitor newly discovered cases, according to Caplan.