Epoch HealthFirst US Case of Sexually Transmitted Fungal Infection: JAMA

Emergence of TMVII: First Sexually Transmitted Fungal Infection in the US and its Broader Implications for Dermatology

The first case of a sexually transmitted skin infection caused by the Trichophyton mentagrophytes type VII (TMVII) fungus has been identified in the United States, highlighting a growing concern for fungal threats worldwide. The case, detailed in JAMA Dermatology, involves a 30-year-old male with a history of multiple male sexual partners, presenting with persistent tinea infections. This discovery raises awareness among healthcare providers about the importance of recognizing and treating atypical fungal infections that may initially mimic other dermatological conditions.

Key Points:

• Identification of TMVII in the US: The first US case of a sexually transmitted infection caused by the TMVII fungus was reported in a 30-year-old male.
• Patient Background: The patient had scaly, reddish rashes on his genitalia, arms, legs, and back. He had traveled within California and to England and Greece before developing the skin lesions.
• Initial Misdiagnosis: Initially diagnosed with dermatophytosis and treated with antifungal medication for four weeks without improvement.
• Diagnosis Confirmation: Later analysis confirmed the infection was caused by TMVII, a sexually transmitted form of fungal ringworm.
• Treatment and Outcome: The patient received further medications and showed improvement.
• Global Trends: TMVII has been increasingly reported in Europe, with 13 cases identified in France last year, primarily among men who have sex with other men.
• Clinical Presentation: TMVII infections can present differently from typical ringworm, often confused with eczema or other conditions, leading to diagnostic delays.
• Physician Awareness: Physicians are advised to directly inquire about rashes in the groin and buttocks, especially in sexually active patients with recent travel history.
• Treatment Challenges: TMVII infections, though difficult to treat and taking months to clear up, have responded to standard antifungal therapies like terbinafine.
• Broader Fungal Threats: The article also highlights concerns over T. indotineae infections, which resist terbinafine treatment and pose additional challenges.
• Emerging Fungal Threats: Increased prevalence of fungal infections, including Candida auris and blastomycosis, raising alarms in healthcare settings due to resistance to standard treatments.

“Since patients are often reluctant to discuss genital problems, physicians need to directly ask about rashes around the groin and buttocks, especially for those who are sexually active, have recently traveled abroad, and report itchy areas elsewhere on the body.”
– John Zampella, senior author of the study

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