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First case report of tinea corporis caused by Trichophyton indotineae in Latin America

Summary

A 21-year-old woman in Argentina developed a persistent skin infection caused by a fungus called Trichophyton indotineae, likely acquired during travel to Mexico. The infection did not respond to common antifungal medications like terbinafine, but responded well to treatment with a special formulation of itraconazole that was completely effective within four weeks. This case represents the first documented occurrence of this emerging fungal pathogen in Latin America and highlights the importance of molecular identification when standard treatments fail.

Background

Trichophyton indotineae is a newly emerged dermatophyte species that has recently spread from India and Asia to Europe and other regions. This species is notable for causing extensive skin lesions and showing poor response to terbinafine treatment in some cases. The case represents the first documented occurrence of this pathogen in Latin America.

Objective

To report the first case of tinea corporis caused by Trichophyton indotineae identified in Argentina and to discuss the clinical presentation, identification methods, and treatment approach for this emerging pathogen.

Results

The isolate was initially identified as Trichophyton mentagrophytes var interdigitale by MALDI-TOF-MS but was confirmed as T. indotineae through DNA sequencing with 99.9% identity. The strain showed terbinafine resistance with MIC of 1.0 μg/ml and itraconazole MIC of 0.25 μg/ml. Treatment with SUBA-itraconazole resulted in complete clinical resolution within 28 days.

Conclusion

This case demonstrates the emergence of T. indotineae in Latin America, likely introduced through travel to endemic areas such as Mexico’s Mayan Riviera. Early identification through molecular methods and treatment with itraconazole is recommended for suspected cases, particularly in patients with travel history to endemic regions or poor response to terbinafine therapy.
  • Published in:Medical Mycology Case Reports,
  • Study Type:Case Report,
  • Source: PMID: 37706043, DOI: 10.1016/j.mmcr.2023.08.004
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