First case of sexually transmitted fungal infection in the USA

As health experts announced on Wednesday, a new sexually transmitted fungal infection has been identified for the first time in the United States.

A study published in the journal JAMA Dermatology reported Wednesday that the first known case of this new form of ringworm in the United States was discovered in a man in his 30s from New York City. The man had been on a trip to England, Greece and California and when he returned to New York City he developed tinea – a type of skin rash – on his penis, buttocks and limbs.

The new form of ringworm is “highly contagious,” according to a press release from New York University’s (NYU) Langone Health about the study. The study, conducted by experts at the medical center and elsewhere, found that the new fungal infection can take months to clear up, even when the patient is treated.

This fungus causes rashes, also called tinea, that can spread to the face, limbs, groin and feet, according to the press release. But unlike the clean circles typical of other forms of ringworm, the tinea caused by this new fungal infection can be confused with lesions caused by eczema, which may lead people not to seek the appropriate treatment immediately, the press release states.

After some tests, health experts determined that the New York man had an infection with the species Trichophyton mentagrophytes type VII (TMVII) – a sexually transmitted form of ringworm that has spread throughout Europe, the press release said. In 2023, 13 cases of the infection were reported in France, mostly in men who have sex with men. The man in New York City said he had sex with several male partners during his trip, but none of them reported similar symptoms, the press release said.

This is “the latest in a group of serious skin infections” to reach the United States, said Dr. Avrom Caplan, the study’s lead author and assistant professor of dermatology at NYU Grossman School of Medicine, in the press release.

Read more: New WHO report: Sexually transmitted diseases are increasing in many regions

“Because patients are often hesitant to discuss genital problems, physicians need to ask directly about rashes in the groin and buttocks, especially in sexually active patients who have recently traveled abroad and report itchy spots elsewhere on the body,” Dr. John Zampella, one of the study’s authors and an associate professor of dermatology at NYU Grossman School of Medicine, said in the press release.

When asked about the potential stigma associated with this infection, Caplan said in an email to TIME that “stigma and fear are unfortunately possible,” especially because the public focus may be on a population recently affected by Mpox. But he stressed that this infection is “very different” from Mpox, a virus formerly known as monkeypox. Mpox, which has been declared a global health emergency by the World Health Organization from 2022 to 2023, can cause a rash on the hands, feet, chest, face, mouth, or near the genitals. Caplan stressed that there is only one reported case of TMVII in the United States and that there is no evidence that it is widespread or endemic in the United States.

Treating these fungal infections can be difficult, but Zampella says so far they seem to be responding to standard treatments, including terbinafine. Terbinafine is an oral tablet used to treat fungal infections, according to the Mayo Clinic.

At the same time, Caplan warned that another skin infection that causes tinea is less responsive to standard treatments. In a study published in JAMA Dermatology In May, Caplan and other researchers studied Trichophyton indotinea, which is widespread in India and has now been reported worldwide. The first two U.S. cases of the infection were reported in 2023, according to the study.

Like TMVII, this infection causes itchy and contagious skin rashes. But unlike TMVII, this infection is often resistant to terbinafine.

The researchers advised doctors to monitor their patients for symptoms of both infections, but added that infection rates in the U.S. have so far been low.

“One of the main reasons for our report is to raise awareness among clinicians that dermatophytes (TMVII) can cause these infections and can be inflammatory, so they can keep this in mind during patient visits,” Caplan said in his email. “For patients, it is a reminder that they should seek medical advice if they have genital lesions that do not heal or are painful, itchy or inflamed.”

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