Department of Medical Mycology, Shanghai Dermatology Hospital, Shanghai, 200443, China.
Department of Dermatology, Shanghai Changzheng Hospital, Second Affiliated Hospital of Naval Military Medical University, Shanghai, 200003, China.
BMC Infect Dis. 2020 Feb 22;20(1):171. doi: 10.1186/s12879-020-4897-z.
Trichophyton benhamiae is a zoophilic dermatophyte that can cause tinea in humans and animals. Lesions caused by T. benhamiae tend to be highly inflammatory, and patients are often infected by animals or other patients infected with T. benhamiae. In this paper, we report the first case of tinea faciei caused by T. benhamiae in a Chinese girl who might be transmitted from a fox.
A 4-year-old girl from HaiNing city developed an itchy, erythematous, and annular plaque on her right face for the past 2 months. Before the lesion appeared, she was in close contact with the fur of a fox for almost 1 week. Septate hyaline hyphae were detected by direct mycological examination of the scales. Cultures grew on Sabouraud's dextrose agar (SDA) at 26 °C for 2 weeks revealed the presence of T. mentagrophytes. A molecular sequencing test confirmed that the isolate was consistent with reference strains to T. benhamiae. Then, the diagnosis of tinea faciei due to T. benhamiae was made. Treatment with terbinafine (oral 125 mg/d) and sertaconazole nitrate cream (topical, twice daily) for 4 weeks was initiated and achieved significant improvement of the skin lesions.
This rare dermatophytosis case highlights the importance of ITS sequencing in helping to recognize rare pathogenic fungi that can be easily misdiagnosed with a conventional morphological diagnosis.
须毛癣菌是一种亲动物性的皮肤癣菌,可引起人类和动物的癣病。由须毛癣菌引起的病变往往具有高度炎症性,患者通常是被动物或其他感染了须毛癣菌的患者感染的。本文报告了首例中国女孩面部癣病由须毛癣菌引起的病例,该女孩可能是从狐狸身上传染的。
来自海宁市的 4 岁女孩,其右侧面部出现瘙痒、红斑和环状斑块已有 2 个月。在皮损出现之前,她曾与狐狸的皮毛密切接触近 1 周。直接镜检鳞屑显示有分隔透明的菌丝。在 26℃的萨布罗琼脂(SDA)上培养 2 周后,生长出须癣毛癣菌。分子测序试验证实,分离株与须毛癣菌的参考株一致。随后,诊断为须毛癣菌引起的面部癣病。开始给予特比萘芬(口服 125mg/d)和硝酸舍他康唑乳膏(外用,每日 2 次)治疗 4 周,皮肤病变显著改善。
这例罕见的皮肤癣菌病病例强调了 ITS 测序在帮助识别易被传统形态学诊断误诊的罕见致病真菌方面的重要性。