Rare sexually transmitted fungus reported for the first time in the USA

For the first time, a case of sexually transmitted ringworm caused by the rare fungus Trichophyton mentagrophytes type VII has been reported in the United States. The case study, published in JAMA Dermatology by physicians at NYU Langone Health, highlights the increasing difficulties in treating fungal infections worldwide.

Mahmoud Ghannoum, professor of dermatology at Case Western Reserve University, emphasized the importance of focusing on antifungal resistance in addition to antibacterial resistance.

The patient, a man in his 30s from New York City, developed a red, itchy rash on his legs, groin and buttocks after having sexual encounters with multiple men while traveling to England, Greece and California. This is the first identification of this fungus in the United States, although 13 similar cases were reported in France last year, mostly in men who have sex with men.

The man’s infection eventually responded to antifungal treatment but took four and a half months to heal. His treatment plan included four weeks of fluconazole with no improvement, followed by six weeks of terbinafine and about eight more weeks of itraconazole. He had no other infections that worsened his condition.

Dr. Avrom Caplan, author of the report and assistant professor at NYU Grossman School of Medicine, urged that while the case should raise awareness, it should not cause public alarm. He advised people who suffer from persistent itchy rashes in areas such as the groin to seek medical attention.

Caplan noted that the infection may resemble an eczema outbreak rather than the typical circular ringworm. Although the infection is not life-threatening, it can leave permanent scars. Caplan had previously noted cases of ringworm of the type Trichophyton indotineae, which is drug-resistant and highly contagious but not sexually transmitted.

Jeremy Gold, a medical epidemiologist at the CDC, stressed that doctors need to consider fungi as possible causes of sexually transmitted diseases, highlighting that fungal infections, unlike bacterial infections, require specific treatments.

Caplan recommends that people with persistent rashes or injuries see a doctor to receive proper treatment.