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

Konstantin V. Grigoryan, Megha M Tollefson, Meredith A. Olson, Catherine C. Newman

Research output: Contribution to journalArticle

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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). Conclusion: T. violaceum and T. soudanense are tinea capitis pathogens, most common among patients of African descent. The pathogens may be underrecognized because such tinea capitis causes are rare in the United States. Most patients had direct contact with persons who had similar symptoms, suggesting contagious nature. Griseofulvin and terbinafine appear to be acceptable treatments against these organisms.

Original languageEnglish (US)
Pages (from-to)912-915
Number of pages4
JournalInternational journal of dermatology
Volume58
Issue number8
DOIs
StatePublished - Aug 1 2019

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Tinea Capitis
Trichophyton
Pediatrics
terbinafine
Griseofulvin
Infection
Arthrodermataceae
Itraconazole
Lost to Follow-Up
Emigration and Immigration
Therapeutics
African Americans
Demography

ASJC Scopus subject areas

  • Dermatology

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Pediatric tinea capitis caused by Trichophyton violaceum and Trichophyton soudanense in Rochester, Minnesota, United States. / Grigoryan, Konstantin V.; Tollefson, Megha M; Olson, Meredith A.; Newman, Catherine C.

In: International journal of dermatology, Vol. 58, No. 8, 01.08.2019, p. 912-915.

Research output: Contribution to journalArticle

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title = "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). Conclusion: T. violaceum and T. soudanense are tinea capitis pathogens, most common among patients of African descent. The pathogens may be underrecognized because such tinea capitis causes are rare in the United States. Most patients had direct contact with persons who had similar symptoms, suggesting contagious nature. Griseofulvin and terbinafine appear to be acceptable treatments against these organisms.",
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AB - 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). Conclusion: T. violaceum and T. soudanense are tinea capitis pathogens, most common among patients of African descent. The pathogens may be underrecognized because such tinea capitis causes are rare in the United States. Most patients had direct contact with persons who had similar symptoms, suggesting contagious nature. Griseofulvin and terbinafine appear to be acceptable treatments against these organisms.

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