June 25, 2024
The California Department of Public Health (CDPH) issued a health advisory warning health care providers to have a high suspicion for Trichophyton mentagrophytes genotype VII (TMVII) in patients presenting with inflammatory, painful, or persistent skin lesions affecting the genitals, buttocks, or face.
The first known case of sexually transmitted TMVII in the United States was reported in June 2024 and involved a patient who traveled to California prior to diagnosis.
TMVII is a rare dermatophyte (e.g., ringworm or tinea) infection that causes highly inflammatory, painful and persistent lesions, often affecting the anogenital or perioral areas.
Given the novelty of sexually transmitted dermatophyte infections and the potential for local spread in the United States, it is important that California physicians be aware of TMVII and other sexually transmitted dermatophytes as an emerging public health concern and understand steps to diagnosis and management.
While TMVII infection may be strongly suspected based on clinical presentation, CDPH is urging clinicians to confirm diagnosis with both in-clinic microscopy and fungal culture. CDPH recommends diagnosis with potassium hydroxide (KOH) preparation and fungal culture of skin scrapings be attempted in all suspected cases of TMVII. Further, CDPH advises that fungal isolates be submitted to select laboratories (listed in the health advisory) for genetic sequencing and species identification.
Sexual activity during recent travel to Europe or Southeast Asia, or partners who have traveled to these locations, may heighten suspicion for TMVII, but absence of such risk factors should not be used to rule out the infection.
For assistance in testing or clinical management of suspected TMVII or other sexually transmitted dermatophyte infections, contact the Sexually Transmitted Diseases Clinical Consultation Network, your local health department, CDPH STD Control Branch at (510) 620-3400 or stdcb@cdph.ca.gov, or U.S. Centers for Disease Control and Prevention at fungaloutbreaks@cdc.gov.
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