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Erythema multiforme associated with superficial fungal disease.

An extremely rare case of erythema multiforme associated with dermatophytosis by Trichophyton rubrum infection was reported in a 19-year-old woman. She had a reddish plaque resembling annular ringworm on her left arm. Treatment with an antifungal cream (clotrimazole) on the infected site cleared the condition in three weeks. Spontaneous regression of erythema multiforme in different parts of the body was recognized when the ringworm infection resolved. In recent years, only two cases have been reported in the English literature.

Adult↗

Postirradiation angiosarcoma.

We describe a patient with angiosarcoma of the scalp arising in an area of radiodermatitis caused by X-ray epilation therapy for scalp ringworm as a child. Radiotherapy has been well documented as a causative factor in the formation of cutaneous malignancies, most notably basal cell and squamous cell carcinoma, but only rarely angiosarcoma. This is now the first reported case of angiosarcoma arising after X-ray epilation therapy for scalp ringworm, and we postulate a causative link between the two events.

Aged↗

Microsporum nanum infection in South Australia.

Two cases of human ringworm caused by the dermatophyte Microsporum nanum are reported from South Australia. M. nanum is the commonest cause of ringworm in pigs and is known to cause porcine infections in Australia. This report shows the value of mycological investigations in determining the possible source of such infections.

Animals↗

The changing epidemiology and emerging patterns of dermatophyte species.

The anthropophilic agents of tinea capitis are being eradicated from their historic areas in developed and developing nations. The one exception is T. tonsurans in the United States and Canada. In these nations, the infections are increasing among black children, probably because of hair style and hygiene habits. Elsewhere in the world, M. canis has become or is becoming the dominant agent of tinea capitis. Tinea corporis reflects either the dominant agent of tinea capitis or the sphere of T. rubrum. Trichophyton rubrum is the most common agent worldwide of crural and pedal disease and often tinea corporis. The other anthropophilic species, T. mentagrophytes var. interdigitale and E. floccosum, are also firmly established, but as a distant second and third. These five species account for most ringworm worldwide. Other species are of lowlevel infection, are rare, are locally endemic, or--in the case of some anthropophiles--are dying out. The only evidence of active evolution among the dermatophytes is seen in M. canis and T. mentagrophytes. In both, host-specific strains have emerged and will probably separate as species. This probably has happened already in the case of the variety interdigitale of T. mentagrophytes.

Animals↗

Fungus invasion of human hair tissue in tinea capitis caused by Microsporum canis: light and electron microscopic study.

Previously, we reported a morphological change of Trichophyton violaceum in hair tissue in black dot ringworm. To investigate the morphology of Microsporum canis in human hais tissue, three cases of tinea capitis by M. canis were examined by both light and electron microscopy. The fungal elements, which were located deeplyin the keratogenous zone, showed nonseptate hyphae in the outer part of the hair cortex. With the upward development of hair tissues, some hyphae invaded the keratinized inner root sheath and were there transformed into arthrospores, which then occupied the large volume of the inner root sheath; each spore was surrounded by an electron-lucent halo. In some affected hair follicles, at the follicular isthmus level, a microabscess composed of polymorphonuclear leukocytes was often formed in the outer root sheath adjacent to the arthrospores in the keratinized inner root sheath. On the other hand, the remaining hyphae in the cortex became degenerated. Fungi did not invade the hair-germinative cells. There is a distinct relationship between the morphological change of fungi and the differentiation of hair cells in tinea capitis by M. canis as well as in that by T. violaceum, although the direction of invasion and pathological roles of fungal elements within hair tissue are significantly different between the two species of fungi.

Child, Preschool↗

A survey of dermatophytes isolated from human patients in the United States from 1979 to 1981 with chronological listings of worldwide incidence of five dermatophytes often isolated in the United States.

A survey of dermatophytes isolated from patients seeking medical advice was made from 1979 to 1981 in the United States. The survey included 54 locations with data from 40 cities and 2 states. Correlations of these data with that of the other localities of the world were made to illustrate the dynamic epidemiology of several common dermatophytes. The most often isolated dermatophyte in this survey was Trichophyton rubrum having 53.66% of the total for these three calendar years. In a chronological listing of ringworm infections caused by this organism, many areas of the world have reported similar increased incidence of this pathogen. Trichophyton tonsurans was isolated 27.85% of the total. A dramatic increase of this pathogen as a cause of tinea capitis has been observed in most cities of the United States. It has been isolated in 25 different countries of the world. The percentage of isolation of Trichophyton mentagrophytes was 8.56%. This percentage may not be near the true incidence of infection by this dermatophyte because the infections are mild and respond to treatment without the individual seeking medical advice. Since the 1950s the percentage of isolations of the total has dropped for T. mentagrophytes in the United States. Epidermophyton floccosum accounted for 4.36% of the total. In a few areas of the world it causes over 30% of the total of dermatophytoses. Microsporum canis was isolated 3.72% of the total in the United States. It has recently been reported to be the dominant agent of tinea capitis in several South American countries, Tucson, Arizona and Kuwait. Once the dominant pathogen of tinea capitis in children in the United States, it was replaced by Microsporum audouinii before 1960. Today in the United States, M. audouinii only accounts for 0.30% of the total. It is considered eliminated as a pathogen in England. In this survey, isolated less than 1.0% of the total were Microsporum gypseum. Microsporum ferrugineum , Microsporum nanum , Microsporum fulvum and Trichophyton schoenleinii . Trichophyton meginii and Trichophyton terrestre were reported isolated but no numerical data were available.

Arthrodermataceae↗

Dermatophytosis of the scalp: incidence, immune response, and epidemiology.

Tinea capitis remains a common infection among the pediatric population of North America. The 'gray patch' Microsporum audouinii infections of the 1950's have been supplanted by the 'black dot' ringworm of Trichophyton tonsurans. The clinical presentation of T. tonsurans infection is quite variable and may be related to specific host T-lymphocyte response. This dermatophytosis is most frequently incurred from contact with an infected child either directly or via a variety of fomites. Current studies indicate that an asymptomatic adult carrier state may also exist which could contribute to the morbidity of this mycosis.

Humans↗

Saprophytic occurrence of Trichophyton mentagrophytes and Microsporum gypseum in the coats of healthy laboratory animals. (Preliminary report).

A group of 199 healthy laboratory animals, comprising 63 guinea pigs; 58 white mice. 47 rats and 31 rabbits, was sampled for the presence of pathogenic dermatophytes. T. mentagrophytes, var. granulare, was isolated in 10% (5-guinea pigs, 6 mice, 6 rats and 2 rabbits) and M. gypseum was found in 7 animals (3 guinea pigs, 3 mice and one rat). No ringworm lesions were observed in the respective animals. This is the first report on such findings in Israel.

Animals↗

Clinical study on the antifungal activity of griseofulvin in the presence of surfactants.

Scales were taken from 128 human volunteers suffering from ringworm infections and grown on Sabourand's media to determine the type of organisms causing the disease. Groups of 32 patients each were treated for sixty days with griseofulvin tablets containing dioctyl sodium sulfosuccinate, cetyl pyridinium chloride and polysorbate 80 respectively, while another group of 32 was given tablets containing griseofulvin only for the same period. The subjects treated with griseofulvin tablets containing surfactants showed a higher rate of cure than those treated with griseofulvin alone.

Adult↗

Review of animal mycoses in Australia.

This review covers the available literature on the mycoses of animals in Australia since the last review published in 1967. Of the cutaneous infections, dermatophytoses have been recorded in a wide range of animals: cattle, horses, goats, pigs, sheep, cats, dogs, mice, guinea-pigs, rabbits, a lion, kangaroos, a camel, koalas and wallabies. These infections were caused by several species and varieties of the genera, Microsporum and Trichophyton. Eight agents of ringworms have been recorded in the horse. Two subcutaneous mycoses, phaeohyphomycosis and sporotrichosis have been reported. Phaeohyphomycosis is becoming more common but sporotrichosis is rare having been recorded only once in a cat. The following systemic mycoses have been recorded: adiaspiromycosis, aspergillosis, candidiasis, cryptococcosis, dactylariosis, fusariomycosis, histoplasmosis, miscellaneous mycoses, mycotic abortion and related conditions, zygomycosis, pythiosis, protothecosis and green algal infections. Cryptococcosis has affected 11 different animal species. Mycotic abortion is a serious disease in Victoria. Pythiosis of horses has been extensively studied in northern Australia.

Animals↗

[Tinea capitis. Therapeutic options in the post-griseofulvin era].

Tinea capitis is the most common dermatophyte infection during childhood. In Germany, only griseofulvin is approved for therapy by regulatory agencies. In recent years, several newer antifungal agents such as itraconazole, fluconazole and terbinafine have broadened the therapeutic armamentarium and are used for the treatment of childhood tinea capitis. Itraconazole and terbinafine seem to be equally or more effective in treatment of tinea capitis within a shorter period of time than griseofulvin. Fluconazole is probably also effective for this indication, although supporting data is limited. Encountered side effects as well as interactions with other drugs appear to be well within acceptable limits for all three drugs. In conclusion, systemic therapy of scalp ringworm with itraconazole and terbinafine, as well as perhaps fluconazole, seems to be an equivalent or a superior therapeutic approach as compared to the use of griseofulvin. For the future, regulatory approval for the use of these newer antifungal agents in tinea capitis of childhood is recommended.

Antifungal Agents↗

Molecular characterization of root-specific chalcone synthases from Cassia alata.

Three cDNAs encoding very similar but unique isoforms of chalcone synthase (EC 2.3.1.74) were isolated from a cDNA library prepared from RNA from root tissue of the Thai medicinal plant Cassia alata L. (ringworm bush, Leguminosae). Gene transcript for these three type-III polyketide synthases was found to accumulate predominantly in roots. The heterologously expressed enzymes accepted acetyl-, n-butyryl-, isovaleryl-, n-hexanoyl-, benzoyl-, cinnamoyl-, and p-coumaroyl-CoA as starter molecules and together with the co-substrate malonyl-CoA, formed multiple products. With the exception of the assay in which acetyl-CoA was used as the starter molecule, all substrates yielded a phloroglucinol derivative resulting from three sequential condensations of acetate units derived from three malonyl-CoA decarboxylations. Every substrate tested also produced two pyrone derivatives, one resulting from two acetate unit condensations (a bis-noryangonin-type pyrone derailment product) and one resulting from three acetate unit condensations (a 4-coumaroyltriacetic acid lactone-type pyrone derailment). C. alata accumulates the flavonoids quercetin, naringenin and kaempferol in roots, suggesting that the in planta function of these enzymes is the biosynthesis of root flavonoids.

Acyltransferases↗

Immunology of fungal infections in animals.

The nature of immunity to fungal infection is discussed predominantly for mammals and birds. T-cell-mediated immunity seems essential for recovery both from cutaneous and mucosal infections (Candida, Malassezia and dermatophytes) and from infections of systemic fungal pathogens (Cryptococcus, Blastomyces, Histoplasma, and Coccidioides). Often chronic progressive disease caused by these fungi is associated with a depression or absence of T-cell-mediated immunity to antigens of the infecting fungus. In contrast recovery from disease, or absence of clinical disease after exposure to these fungi, is associated with the presence of strong T-cell-mediated immune responses to the fungus. The activation of macrophages and the stimulation of epidermal growth and keratinization are the processes induced by T-cell-mediated immunity which result in the resolution of systemic or cutaneous and mucosal disease. Other cell types, for example NK cells and PMNs (polymorphonuclear leucocytes), may be important in these diseases in reducing the effective amount of inoculum to which an animal is exposed and thereby reducing the likelihood of disseminated disease. Invasive opportunistic fungi (Candida, Aspergillus, Mucorales) are resisted by PMNs which attach to the hyphae or pseudohyphae and damage them via an extracellular mechanism. Other host cell types may be important in natural resistance, fungal spores being handled by the macrophages which, under conditions when animals are not immunosuppressed, are likely to be an effective first line of defense. Subcutaneous pathogens and miscellaneous other fungal diseases are discussed from a point of view of host immunity and immunodiagnosis. Vaccine development for ringworm and for other mycoses is discussed.

Animals↗

Rapid identification of Trichophyton tonsurans by specific PCR based on DNA sequences of nuclear ribosomal internal transcribed spacer (ITS) 1 region.

BACKGROUND: Trichophyton tonsurans, a dermatophyte implicated in an international epidemic of tinea capitis, was also found to be responsible for infecting wrestling and Judo athletes nationwide in Japan since 2001. OBJECTIVE: A rapid and highly accurate means of identifying this pathogen has been required to control the infection. We have developed a T. tonsurans-specific PCR method based on the DNA sequences of the nuclear ribosomal internal transcribed spacer 1 region. SUBJECTS: Eighteen species of six genera of standard strains and 75 strains of clinically isolated Trichophyton species were used in this study. METHODS: A T. tonsurans-specific PCR primer pair (tonsF1 and tonsR1) was designed on the nuclear ribosomal internal transcribed spacer 1 region, located between 18S and 5.8S rDNA. Fungal DNA was extracted from the colonies grown on culture plates, and the specificity of the PCR primers was tested. RESULTS: The specific PCR product was amplified from the standard strain of T. tonsurans and from five strains isolated from black dot ringworms, but there was no band from the 70 clinical isolates of other Trichophyton species. This T. tonsurans-specific PCR method was able to detect 10 pg of T. tonsurans genomic DNA with ethidium bromide staining. CONCLUSIONS: A PCR identification system specific for T. tonsurans is rapid, sensitive, and specific.

DNA Probes↗

Morbidity in 3-7-month-old dairy calves in south-western Sweden, and risk factors for diarrhoea and respiratory disease.

The health status of 2947 heifer calves born in 1998 and raised in 122 Swedish dairy herds was monitored from birth to 210 days of age. Disease occurrence was recorded by farmers and by veterinarians who visited the farms six times yearly, examined the calves clinically and auscultated their lungs. The incidence risks of diarrhoea, ringworm and clinical respiratory-tract disease (CRTD) in calves from 3 to 7 months of age were 2.7%, 5.6% and 5.7%, respectively. The herd-level incidence risks of the three diseases were zero in 63.1%, 76.2% and 48.4%, respectively, of the herds. In positive herds incidence risks were 2.2-46.4%, 2.6-47.0% and 2.2-53.3%, respectively. The associations between the potential risk factors age at first grazing, air quality, birth place, feeding of colostrum, hygiene, number of animals, age range within the pen or building, pen area, pen location, previous housing type, present housing type, previous disease and season, and each of three binary outcome variables (diarrhoea, increased respiratory sounds and CRTD) were evaluated using two-level (calf; herd) variance component logistic models. Predictors significantly associated (P<0.05) with diarrhoea were pen area, season and the interaction between pen location and previous CRTD. Previous CRTD, season and heart girth at weaning were significantly associated with moderately to severely increased respiratory sounds. Predictors significantly associated with CRTD were previous diarrhoea, previous housing and season. It was concluded that the incidence of diarrhoea and CRTD in 91-210-day-old Swedish dairy calves is higher than previously reported from dairy herds in Sweden and the USA, and that diarrhoea, increased respiratory sounds and CRTD are associated with season, a history of disease during the first 90 days of age and, to some extent, housing factors.

Animals↗

The public health laboratory service (PHLS) and its role in the control of zoonotic disease.

The aetiology of zoonotic infections embraces organisms from every branch of the microbial world. In addition, zoonoses must be considered as a truly global problem, both in terms of their distribution and the measures required for their control. Within the UK, zoonotic disease is considered to be less frequent than in some less developed parts of the world. However, its contribution to overall morbidity and mortality within the UK population is not well established. In an attempt to define the impact of zoonotic infection more accurately, a multicentre prospective study of disease in farmers in England and Wales was initiated by the PHLS in 1992. The study involved the completion by participants of annual questionnaires dealing with their own health and the range and health of their livestock. Our results confirmed that some infections occur frequently in farmers. For example, ringworm and Q fever were associated with contact with cattle and orf with the handling of sheep. Some findings were unexpected; the incidence and prevalence of leptospirosis, for example, were far lower in the farmers than had been anticipated, whilst there was a higher than expected incidence and prevalence of hantavirus infection. The success of the project was largely due to the adoption of a multidisciplinary approach and the continuity of funding which enabled the study of the same cohort to continue for 7 years.

Animals↗

Morbidity in Swedish dairy calves from birth to 90 days of age and individual calf-level risk factors for infectious diseases.

The health of 3081 heifer calves born in 122 dairy herds in the south-west of Sweden from 1 January to 31 December, 1998, was monitored from birth until 90 days of age. The calves were kept either in individual pens (n=2167), in group pens, with 3-8 calves to a pen and manual feeding of milk (n=440), in group pens with 6-30 calves per pen and an automatic milk-feeding system (n=431), or with their dams (n=43). Disease incidence was recorded by farmers and project veterinarians, who clinically examined the calves and auscultated their lungs every 2-3 months. A disease was graded as 'severe' if the general loss of condition or of appetite in the calf continued for >2 days or if the animal suffered severe weight loss due to the disease. The effects of season, breed, housing, and type of colostrum feeding, and time, place and supervision of calving on the incidences of diarrhea, severe diarrhea, respiratory disease, other infectious disease and moderately to severely increased respiratory sounds, were analyzed by logistic-regression models (with herd as a random effect). The total morbidity rate was 0.081 cases per calf-month at risk. Incidence rates of arthritis, diarrhea, omphalophlebitis, respiratory disease and ringworm were 0.002, 0.035, 0.005, 0.025 and 0.009 cases per calf-months at risk, respectively. The odds ratios for diarrhea and severe diarrhea were increased in Swedish Red and Whites (OR: 1.6, 2.3) and in calves that received colostrum from first-lactation cows (OR: 1.3-1.8), and for severe diarrhea in calves born in summer or that received colostrum through suckling (OR: 1.7, 1.8). The odds ratios for respiratory disease and increased respiratory sounds were increased in calves housed in large-group pens with an automatic milk-feeding system (OR: 2.2, 2.8). Supervision of calving was associated with a decreased odds ratio for respiratory disease (OR: 0.7) and birth in individual maternity pen or tie stalls with a decreased odds ratio for increased respiratory sounds (OR: 0.5-0.6). Cross-breeds with beef breeds were associated with increased odds ratios for increased respiratory sounds (OR: 2.1-4.3) and colostrum from second-lactation cows and birth during night for other infectious disease (OR: 1.6, 1.5).

Aging↗

Microsporum nanum infection in hog farmers.

Microsporum nanum is a dermatophyte that can cause disease in both man and animals and is most frequently associated with ringworm infection in pigs. Human infections are rare in the literature. Three new cases of human M. nanum infection are reported here. Two patients had inflammatory tinea faciei and one had tinea cruris. The patients were successfully treated with clotrimazole or miconazole cream, sometimes combined with griseofulvin. All three patients were hog farmers and lived in the same small rural area. Occupational exposure is suggested as the cause of infection.

Adult↗