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Treatment and diagnostic challenges associated with the novel and rapidly emerging antifungal-resistant dermatophyte, Trichophyton indotineae

Summary

A new type of fungal infection called Trichophyton indotineae has emerged and spread globally, particularly from India. It causes widespread skin infections that are difficult to treat because the fungus resists common antifungal medications. Doctors and laboratories need to be aware of this infection to properly identify it and choose effective treatments, especially for patients with travel history to affected regions.

Background

Trichophyton indotineae is a recently discovered dermatophyte species first reported from India that causes recalcitrant dermatophytosis resistant to common antifungal medications. The species has rapidly spread globally and reached epidemic proportions in the Indian subcontinent, now accounting for 38% of dermatophyte isolates in the United Kingdom.

Objective

This mini review examines the emergence of T. indotineae, its diagnostic and treatment challenges, and current management approaches. The goal is to improve clinician and laboratory awareness to enable prompt diagnosis, appropriate treatment selection, and implementation of effective public health measures to prevent further spread.

Results

T. indotineae is transmitted primarily person-to-person and causes extensive, inflammatory dermatophytosis often resistant to first-line antifungals like terbinafine. Diagnosis requires molecular methods such as ITS sequencing or specialized MALDI-TOF MS databases since culture and physiological characteristics cannot reliably distinguish it from related species. Itraconazole remains the preferred treatment option.

Conclusion

T. indotineae represents a significant emerging global health challenge requiring improved diagnostic capacity, better surveillance systems, development of new antifungal agents, and heightened clinical awareness for appropriate patient management and infection prevention.
  • Published in:Journal of Clinical Microbiology,
  • Study Type:Literature Review,
  • Source: PMID: 40497720, doi: 10.1128/jcm.01407-24
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