Four cases of sexually transmitted fungal infection reported in New York

A paper published last week in Morbidity and Mortality Weekly Report describes four US cases of an emerging, sexually transmitted fungal infection.

The infections were caused by Trichophyton mentagrophytes type VII (TMVII), a sexually transmitted fungus that causes genital tinea (ringworm). TMVII infections have previously been reported in patients who had contact with sex workers in Southeast Asia and men who have sex with men (MSM) in France. The first US case was reported in June in a man who reported sexual contact with multiple men while traveling in Europe and California.

The four case-patients were diagnosed with tinea between April and July, and fungal cultures and DNA sequencing identified TMVII as the cause of the infection. All four patients were men aged 30 to 39 years from New York City who reported recent sexual contact with other men; one was a sex worker, two had sex with each other, and one reported recent travel to Europe. All presented with rashes on the face, buttocks, or genitals and were successfully treated with antifungals.

The authors of the report, including clinicians from Columbia University Irving Medical Center and New York University Grossman School of Medicine, say healthcare providers should be aware that TMVII can spread through sexual contact and cause lesions in the genitals, buttocks, face, trunk, or extremities and should advise patients with TMVII infection about the importance of avoiding skin-to-skin contact with the affected areas.

"Public health surveillance, health care provider and patient education and awareness, and increased access to dermatophyte identification and antifungal susceptibility testing could help detect, monitor, and prevent the spread of TMVII," they wrote.