Pediatric tinea capitis caused by Trichophyton violaceum and Trichophyton soudanense in Rochester, Minnesota, United States

Abstract

Background Tinea capitis is a common pediatric dermatophyte infection. Its main pathogen in the United States is Trichophyton tonsurans accounting for greater than 95% of the infections. Other pathogens including Trichophyton violaceum and Trichophyton soudanense are common in Africa. Although rare in the United States, their prevalence is increasing, possibly because of immigration patterns. We evaluated the demographic characteristics, treatments, and resolution among pediatric patients with T. violaceum and T. soudanense infections. Methods Retrospective chart review of patients from Mayo Clinic in Rochester, Minnesota, United States, with cultures positive for T. violaceum and T. soudanense from 1997 to 2014. Age at presentation, ethnic background, date and location of culture, and treatment were extracted. Results In total, 81 children (age <18 years) were identified as positive for T. violaceum and T. soudanense (mean [range] age, 6.0 [1-17] years). Race/ethnicity of 67 patients (82.7%) was African; four, African-American; three, white; two, Asian; and five, unknown. After culture identification, 64 patients (79.0%) received griseofulvin; five, terbinafine; and three, itraconazole; nine patients had no documented oral antifungal therapy. Of 28 patients not lost to follow-up, median time to clinical cure was 2.3 months (interquartile range, 2.8 months).

Tinea capitis: A single‐institution retrospective review from 2010 to 2015

“…The literature describing tinea capitis caused by T violaceum and T soudanense also supports the non‐inflammatory, seborrheic dermatitis‐like presentations we found in our population, though there is significant heterogeneity of clinical presentations . Erythema can be subtle in darker skin types; however, inflammation in our study was defined as pustules, boggy indurated plaques, or lymphadenopathy so as to avoid misclassification.…”

“…The importance of the increasing prevalence of T soudanense and T violaceum is in the recognition of the distinct clinical presentation that can be seen with these dermatophytes. The retrospective nature of our study limited our ability to evaluate treatment outcomes, but prior literature does not support any difference in response to treatment or need for different treatment duration …”

Estimation of the burden of tinea capitis among children in Africa

“…Trichophyton soudanense which is also found in some parts of Asia was also common in Africa, eminently in West African countries and Gabon 22,27,30,65,66 . Cases of T soudanense have also been documented in the United States 65,67 . Of concern, M canis , a zoophilic dermatophyte which mainly infects cats, infrequently dogs and humans, is prevalent in parts of Northern Africa like Morocco, Egypt and Tunisia 14,15 .…”

A Scoping Review of the Health of African Immigrant and Refugee Children

“…Tinea capitis is a common infectious disease among AMC in New Zealand [38], Israel [39], Spain [40,41], and Australia [42]. Other scalp infections from Trichophyton violaceum and Trishophyton soudanense are also present in AMC living in Sweden and the United States [43,44].…”