New Infectious Strain of Fungus Triggers Health Alert in New York.

Health officials in New York are on high alert after the identification of the first case of a sexually transmitted ringworm infection caused by a new and highly infectious strain of fungus, Trichophyton mentagrophytes type VII (TMVII). This development marks the first known instance of this particular strain in the United States.

Dr. Avrom S. Caplan, an assistant professor in the NYU Grossman School of Medicine dermatology department, emphasized this discovery’s significance.

Healthcare providers should be aware that Trichophyton mentagrophytes type VII [TMVII] is the latest in a group of severe skin infections to have now reached the United States

Dr. Caplan stated, as reported by The New York Post.

The patient, a 30-year-old man, exhibited a rash on his penis, buttocks, and limbs, according to a case study co-authored by Dr. Caplan. The man, who has not been identified, reported having traveled to England, Greece, and California, where he engaged in sexual activities with men, none of whom had disclosed similar symptoms.

The spread of TMVII has been notably increasing in Europe, particularly among men who have sex with men. Due to the sensitive nature of the infection, patients often hesitate to discuss genital issues. Dr. John G. Zampella, the senior author of the study, advises physicians to inquire directly about rashes in the groin and buttocks areas, especially for patients who are sexually active, have traveled recently, and report itchy areas elsewhere on their body.

Standard antifungal therapies, such as terbinafine (Lamisil), appear to be effective against TMVII, although the infection may take several months to clear up. The similarity of TMVII-induced rashes to eczema lesions can lead to delays in appropriate treatment.

Additionally, the presence of Trichophyton indotineae, another resistant fungal strain first confirmed in the US last year and widespread in India, poses further challenges. Researchers from NYU Grossman School of Medicine have analyzed data from 11 patients treated for Trichophyton indotineae in NYC hospitals between May 2022 and May 2023. Standard doses of terbinafine were ineffective for seven of these patients, potentially due to genetic mutations in the fungus.

The antifungal medication itraconazole has shown more promise but comes with its own set of challenges, including potential interactions with other medications and side effects like nausea and diarrhea.

Despite the emergence of these strains, the overall rates of TMVII and Trichophyton indotineae infections in the US remain low. Dr. Caplan and his team aim to expand their research into these fungal species in the coming months, providing new insights into the mechanisms behind their resistance to standard treatments.

“These findings offer new insight into how some of the fungal skin infections spreading from South Asia can evade our go-to therapies,” Dr. Caplan noted. “Beyond learning to recognize their misleading signs, physicians will need to ensure their treatment addresses each patient’s quality of life needs.”

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