According to a weekly report from the US Centers for Disease Control and Prevention (CDC), a highly contagious, drug-resistant skin infection that has never before been diagnosed on US soil has been detected.
This infection is known as ringworm, a disease caused by dermatophyte fungi of the genus “Trichophyton” that usually affects the scalp, skin, or nails. The fungi are spread by direct contact with the skin of infected animals or people, as well as indirectly through items such as hair clippers and shower floors.
In recent years, a severe, drug-resistant ringworm epidemic has emerged in South Asian countries due to the emergence and transmission of the fungus “Trichophyton indotineae.” This infection has possibly been driven by the inappropriate use of drugs to treat it, including antifungals, antibiotics, and corticosteroids.
On Feb. 28, a New York City dermatologist reported to health authorities two cases of women with severe ringworm that had not improved with the usual treatments, raising concerns that the infection was caused by “Trichophyton indotineae.”
The first patient, a 28-year-old woman, developed a generalized rash in the summer of 2021 and was diagnosed with ringworm after giving birth in January 2022. She started oral treatment with terbinafine, but the rashes persisted until she was switched to itraconazole, which resulted in improvement after four weeks. This woman, with no history of international travel, is being monitored for a possible recurrence of infection.
The second patient, a 47-year-old woman, developed a severe case of ringworm while in Bangladesh in the summer of 2022. Upon her return to the US, she sought emergency medical care three times and was prescribed various topical treatments without improvement. Beginning in December of last year, he received two oral drug therapies, each lasting four weeks, with the last one resulting in an 80% improvement.
According to the CDC, skin samples taken from both women initially determined that the infection was caused by the fungus “Trichophyton mentagrophytes,” but further analysis identified “Trichophyton indotineae” as the responsible agent.
The World Health Organization considers antimicrobial resistance (AMR) to be a major global public health threat, causing 1.27 million deaths per year and mainly affecting low- and middle-income countries.
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