Igelpilze in einer Münchner Hautarztpraxis

Abstract

Patient 1: After contact to a central European hedgehog (Erinaceus europaeus), a 50-year-old female with atopy developed erythrosquamous tinea manus on the thumb and thenar eminence of the right hand. The patient had previously been scalded by hot steam at the affected site. The zoophilic dermatophyte Trichophyton erinacei could be cultured from the hedgehog as well as from scrapings from the woman's skin. Antifungal treatment of the hedgehog was initiated using 2 weekly cycles of itraconazole solution (0.1 ml/kg body weight, BW). In addition, every other day enilconazole solution was used for topical treatment. The patient was treated with ciclopirox olamine cream and oral terbinafine 250 mg daily for 2 weeks, which led to healing of the Tinea manus .Patient 2: An 18-year-old woman presented for emergency consultation with rimmed, papulous, vesicular and erosive crusted skin lesions of the index finger, and an erythematous dry scaling round lesion on the thigh. The patient worked at an animal care facility, specifically caring for hedgehogs. One of the hedgehogs suffered from a substantial loss of spines. Fungal cultures from skin scrapings of both lesions yielded T. erinacei. Treatment with ciclopirox olamine cream and oral terbinafine 250 mg for 14 days was initiated which led to healing of the lesions. Identification of all three T. erinacei isolates from both patients and from the hedgehog was confirmed by sequencing of the internal transcribed spacer (ITS) region of the ribosomal DNA, and of the translation elongation factor (TEF)-1-alpha gene. Using ITS sequencing discrimination between T. erinacei strains from European and from African hedgehogs is possible. T. erinacei should be considered a so-called emerging pathogen. In Germany the zoophilic dermatophyte T. erinacei should be taken into account as causative agent of dermatomycoses in humans after contact to hedgehogs.

Epidemiology of Dermatophytoses in Switzerland According to a Survey of Dermatophytes Isolated in Lausanne between 2001 and 2018

“…However, it is also very possible that the infection of dogs with N. persicolor could occur through contact with soil. The origin of T. erinacei in a patient could be traced to contact with a hedgehog [16], as was the case for several cases of this emerging dermatophyte species in Spain and Germany [29][30][31][32].…”

Spread of Terbinafine-Resistant Trichophyton mentagrophytes Type VIII (India) in Germany–“The Tip of the Iceberg?”

“…Abbreviations: SQLE, squalene epoxidase; ITS, internal transcribed spacer; TEF1-α, translation elongation factor 1-α; MIC, minimum inhibitory concentration; NCBI, National Center for Biotechnology Information, Bethesda, Maryland; DSM, Deutsche Sammlung von Mikroorganismen und Zellkulturen (German Collection of Microorganisms and Cell Cultures), Braunschweig, Germany; f, female; m, male. For confirmation of the suspected dermatophyte species, Sanger sequencing of the ITS regions of rDNA genes (mainly the regions ITS 1, 5.8 S rRNA, ITS 2) and TEF1-α gene was performed for all isolates [6][7][8][9]. This required PCR amplification of a ∼900 bp DNA fragment using universal primers that bind to flanking pan-fungal sequence regions: V9G (5'-TTACGTCCCTGCCCTTTGTA-3') and LS266 (5'-GCATTCCCAAACAACTCGACTC-3').…”

A Polyphasic Approach to Classification and Identification of Species within the Trichophyton benhamiae Complex

“…T. cf. erinacei strains seem to be quite rare but have been isolated in Africa, Europe, and North America during the past few decades [19,34]. Screening of 412 European hedgehogs at a wildlife center in Paris did not yield any strains of this genotype [35].…”

“…They isolated several strains from European hedgehogs of the divergent T. cf. erinacei genotype [34]. Kargl et al concluded that the divergent ITS genotype of the T. cf.…”