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Kottferová L, Molnár L, Major P, Sesztáková E, Kuzyšinová K, Vrabec V, Kottferová J. Hedgehog Dermatophytosis: Understanding Trichophyton erinacei Infection in Pet Hedgehogs and Its Implications for Human Health. J Fungi (Basel) 2023; 9:1132. [PMID: 38132733 PMCID: PMC10744110 DOI: 10.3390/jof9121132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
Pet hedgehogs, which are increasingly favoured companions, have garnered attention due to their potential as carriers of zoonotic diseases. These small insectivorous mammals, native to Europe, Asia, and Africa, are commonly kept as pets. The encroachment of humans into hedgehog habitats has brought these animals closer to people, raising concerns about disease transmission. This article reviews the current knowledge regarding zoonotic disease associated with pet hedgehogs, with a particular focus on mycotic infections caused by Trichophyton erinacei. Data from various regions and hedgehog species are synthesised to assess the significance of pet hedgehogs as potential reservoirs and transmitters of zoonotic pathogens. Our study highlights the importance of understanding the health risks associated with pet hedgehogs and underscores the need for continued research to mitigate zoonotic disease transmission from these potentially disease-carrying companions.
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Affiliation(s)
- Lucia Kottferová
- Clinic of Birds, Exotic and Free Living Animals, University of Veterinary Medicine and Pharmacy, Komenského 73, 04181 Košice, Slovakia; (L.K.); (L.M.); (E.S.); (K.K.); (V.V.)
| | - Ladislav Molnár
- Clinic of Birds, Exotic and Free Living Animals, University of Veterinary Medicine and Pharmacy, Komenského 73, 04181 Košice, Slovakia; (L.K.); (L.M.); (E.S.); (K.K.); (V.V.)
| | - Peter Major
- Clinic of Birds, Exotic and Free Living Animals, University of Veterinary Medicine and Pharmacy, Komenského 73, 04181 Košice, Slovakia; (L.K.); (L.M.); (E.S.); (K.K.); (V.V.)
| | - Edina Sesztáková
- Clinic of Birds, Exotic and Free Living Animals, University of Veterinary Medicine and Pharmacy, Komenského 73, 04181 Košice, Slovakia; (L.K.); (L.M.); (E.S.); (K.K.); (V.V.)
| | - Katarína Kuzyšinová
- Clinic of Birds, Exotic and Free Living Animals, University of Veterinary Medicine and Pharmacy, Komenského 73, 04181 Košice, Slovakia; (L.K.); (L.M.); (E.S.); (K.K.); (V.V.)
| | - Vladimír Vrabec
- Clinic of Birds, Exotic and Free Living Animals, University of Veterinary Medicine and Pharmacy, Komenského 73, 04181 Košice, Slovakia; (L.K.); (L.M.); (E.S.); (K.K.); (V.V.)
| | - Jana Kottferová
- Department of Public Veterinary Medicine and Animal Welfare, University of Veterinary Medicine and Pharmacy, Komenského 73, 04181 Košice, Slovakia;
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Phaitoonwattanakij S, Leeyaphan C, Bunyaratavej S, Chinhiran K. Trichophyton erinacei Onychomycosis: The First to Evidence a Proximal Subungual Onychomycosis Pattern. Case Rep Dermatol 2019; 11:198-203. [PMID: 31341462 PMCID: PMC6639565 DOI: 10.1159/000501424] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 06/07/2019] [Indexed: 11/19/2022] Open
Abstract
Trichophyton erinacei is an emerging cause of dermatophyte infections, which are frequently isolated from hedgehogs. Nail infections from T. erinacei are rarely reported. We describe the case of a 23-year-old Thai female who had a history of systemic lupus erythematosus with lupus nephritis type III and who developed widespread skin and nail infections caused by T. erinacei that were most likely transmitted from a hedgehog. Although the patient did not demonstrate a clinical improvement or mycological cure following systemic itraconazole and fluconazole treatment, she achieved clinical and mycological cures after terbinafine therapy. A drug susceptibility test should be performed in patients with T. erinacei infections to facilitate decision-making about antifungal therapy. Here, we are the first to report a case of proximal subungual onychomycosis from a T. erinacei infection.
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Affiliation(s)
| | - Charussri Leeyaphan
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sumanus Bunyaratavej
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kittipoom Chinhiran
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Kromer C, Nenoff P, Uhrlaß S, Apel A, Schön MP, Lippert U. Trichophyton erinacei Transmitted to a Pregnant Woman From Her Pet Hedgehogs. JAMA Dermatol 2018; 154:967-968. [PMID: 29847619 DOI: 10.1001/jamadermatol.2018.1124] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Christian Kromer
- Department of Dermatology, Venereology, and Allergology, University Medical Center, Göttingen, Germany
| | - Pietro Nenoff
- Laboratory for Medical Microbiology, Rötha/OT Mölbis, Germany
| | - Silke Uhrlaß
- Laboratory for Medical Microbiology, Rötha/OT Mölbis, Germany
| | - Antje Apel
- Department of Dermatology, Venereology, and Allergology, University Medical Center, Göttingen, Germany
| | - Michael Peter Schön
- Department of Dermatology, Venereology, and Allergology, University Medical Center, Göttingen, Germany
| | - Undine Lippert
- Department of Dermatology, Venereology, and Allergology, University Medical Center, Göttingen, Germany
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Abarca ML, Castellá G, Martorell J, Cabañes FJ. Trichophyton erinacei in pet hedgehogs in Spain: Occurrence and revision of its taxonomic status. Med Mycol 2016; 55:164-172. [PMID: 27486214 DOI: 10.1093/mmy/myw057] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 03/03/2016] [Accepted: 06/07/2016] [Indexed: 11/13/2022] Open
Abstract
Hedgehogs have increased in popularity as pets in Spain but there are no data of infection rates of this exotic animal with dermatophytes in our country. During the period of 2008-2011 a total of 20 pet hedgehogs (19 African pygmy hedgehogs and 1 Egyptian long-eared hedgehog) suspected of having dermatophytoses were studied. This is the first survey of the occurrence of T. erinacei in household hedgehogs in Spain. The T. erinacei infection rate was 50% (9 out of 19 African pygmy hedgehogs, and the one Egyptian long-eared hedgehog surveyed). Morphological identification of the isolates was confirmed by molecular analysis. All the strains had the same ITS sequence and showed 100% sequence similarity to T. erinacei type strain CBS 511.73 (AB 105793). The Spanish isolates were confirmed as T. erinacei urease positive. On the basis of ITS sequences, T. erinacei is a species close to but separate from the taxa included in the A. benhamiae complex. Review of the current literature on DNA-based methods for identification of species included in this complex has highlighted the urgent need to reach a consensus in species circumscription and classification system accepted by all mycologists.
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Affiliation(s)
- M L Abarca
- Veterinary Mycology Group, Department of Animal Health and Anatomy
| | - G Castellá
- Veterinary Mycology Group, Department of Animal Health and Anatomy
| | - J Martorell
- Department of Animal Medicine and Surgery and Veterinary Teaching Hospital, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - F J Cabañes
- Veterinary Mycology Group, Department of Animal Health and Anatomy
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Clinical and Laboratory Features of Six Cases of Candida and Dermatophyte Folliculitis and a Review of Published Studies. Mycopathologia 2015; 181:97-105. [DOI: 10.1007/s11046-015-9939-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 08/27/2015] [Indexed: 10/23/2022]
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Borges-Costa J, Martins MDL. Trichophyton erinacei skin infection after recreational exposure to an elephant in Southeast Asia. Pathog Glob Health 2014; 108:58-9. [PMID: 24548162 DOI: 10.1179/2047773213y.0000000117] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Zoophilic fungal infections are a prevalent disease in tropical countries and clinicians must consider them in the differential diagnosis of pruritic skin lesions. We report a clinical case of Trichophyton erinacei skin infection after recreational exposure to an Asian Elephant. As far as we were able to search the literature, it is the first case described after contact with elephants.
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Concha M, Nicklas C, Balcells E, Guzmán AM, Poggi H, León E, Fich F. The first case of tinea faciei caused by Trichophyton mentagrophytes var. erinacei isolated in Chile. Int J Dermatol 2012; 51:283-5. [PMID: 22348562 DOI: 10.1111/j.1365-4632.2011.04995.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Trichophyton mentagrophytes var. erinacei is a zoophilic dermatophyte transmitted by hedgehogs which human infections manifest as highly inflammatory and pruritic eruptions. METHODS We report a 21-year-old woman who presented with a two-week history of a pruritic scaly erythematous plaque on the nose. The patient had kept hedgehogs as pets, and one had bitten her on the tip of the nose two months prior to the appearance of the nasal lesion. RESULTS Fungal culture from the scales on the tip of the patient's nose was compatible with T. mentagrophytes var. erinacei. The strains isolated from cultures made from samples taken from the noses and ears of the pet hedgehogs were morphologically similar to the strain isolated from the patient. Morphological identification was confirmed by sequencing the internal transcribed spacer. The lesion was diagnosed as tinea faciei, and therapy was initiated with topical and systemic terbinafine 250mg/day for eight weeks, which resulted in complete improvement. CONCLUSIONS Trichophyton mentagrophytes var. erinacei is the most common dermatophyte isolated in hedgehogs. Usually T. mentagrophytes var. erinacei infection manifests as an extremely inflammatory and pruritic eruption that is confined to the site of contact with the hedgehog. Although the identification of T. mentagrophytes by traditional methods is possible, identification by ITS region analysis is a fast, simple, and increasingly available method. The increasing frequency of the practice of keeping exotic animals as pets has resulted in the emergence of several zoonotic diseases that can potentially be transmitted to humans.
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Affiliation(s)
- Marcela Concha
- Departments of Dermatology Infectology Clinical Laboratory, Pontifical Catholic University of Chile, Santiago, Chile.
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Durdu M, Ilkit M. First step in the differential diagnosis of folliculitis: cytology. Crit Rev Microbiol 2012; 39:9-25. [DOI: 10.3109/1040841x.2012.682051] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Lee DW, Yang JH, Choi SJ, Won CH, Chang SE, Lee MW, Choi JH, Moon KC, Kim MN. An unusual clinical presentation of tinea faciei caused by Trichophyton mentagrophytes var. erinacei. Pediatr Dermatol 2011; 28:210-2. [PMID: 21504458 DOI: 10.1111/j.1525-1470.2011.01391.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Trichophyton mentagrophytes var. erinacei, the natural host of which is the hedgehog, has been found to cause highly inflammatory and pruritic eruptions, including tinea manuum, tinea corporis, nail infection, kerion, scalp infection, and tinea barbae. To our knowledge, however, no reports have been made of tinea faciei caused by Trichophyton mentagrophytes var. erinacei in the English language literature. We provide here the case of tinea faciei caused by Trichophyton mentagrophytes var. erinacei.
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Affiliation(s)
- Deok-Woo Lee
- Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
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Hsieh CW, Sun PL, Wu YH. Trichophyton erinacei Infection from a Hedgehog: A Case Report from Taiwan. Mycopathologia 2010; 170:417-21. [DOI: 10.1007/s11046-010-9333-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2010] [Accepted: 06/05/2010] [Indexed: 10/19/2022]
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Abstract
The hedgehog is an in Germany previously unrecognized source of human ringworm. Eight hedgehog caretakers from Göttingen and the surrounding area developed dermatophytosis caused by Trichophyton erinacei. Four patients who handled the animals without gloves developed lesions on the hands that were more in keeping with hand eczema, leading to a delay in diagnosis. The other caretakers who wore gloves presented with typical ringworm on the arms, the big toe, the back, the abdomen, and the thighs. Their typical clinical features led to an early diagnosis and treatment.
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Affiliation(s)
- S Schauder
- Universitäts-Hautklinik Göttingen, von-Siebold-Strasse 3, 37075, Göttingen, Germany.
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Mochizuki T, Takeda K, Nakagawa M, Kawasaki M, Tanabe H, Ishizaki H. The first isolation in Japan of Trichophyton mentagrophytes var. erinacei causing tinea manuum. Int J Dermatol 2005; 44:765-8. [PMID: 16135148 DOI: 10.1111/j.1365-4632.2004.02180.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Takashi Mochizuki
- Department of Dermatology, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
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Fumeaux J, Mock M, Ninet B, Jan I, Bontems O, Léchenne B, Lew D, Panizzon RG, Jousson O, Monod M. First report of Arthroderma benhamiae in Switzerland. Dermatology 2004; 208:244-50. [PMID: 15118380 DOI: 10.1159/000077311] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Dermatophytes are usually identified on the basis of macroscopic characteristics and microscopic examination of the cultures. Identification of dermatophytes often remains difficult or uncertain because there are variations from one isolate to another and overlapping characteristics between species. OBJECTIVE To identify dermatophyte species producing numerous microconidia and resembling Trichophyton mentagrophytes by DNA sequence analysis. METHODS The complete ITS1 + 5.6s + ITS2 rDNA region of various dermatophytes isolated in culture was amplified by PCR and sequenced. RESULTS Nine isolates of a fast-growing dermatophyte species were identified as Arthroderma benhamiae by DNA sequencing. Retrospective investigations revealed that the isolates were from 8 children and 1 adult suffering from inflammatory dermatophytosis. Eight of the 9 patients had had previous contact with rodents, mostly guinea pigs. CONCLUSION It is the first time that A. benhamiae is reported in Switzerland. In cases of dermatophytosis attributed to A. benhamiae, a rodent is the most likely cause of infection.
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Affiliation(s)
- Janine Fumeaux
- Service de Dermatologie (DHURDV), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Frangoulis E, Athanasopoulou B, Katsambas A. Etiology of tinea capitis in Athens, Greece - a 6-year (1996-2001) retrospective study. Atiologie der Tinea capitis in Athen, Griechenland. Retrospektive Analyse der Jahre 1996-2001. Mycoses 2004; 47:208-12. [PMID: 15189185 DOI: 10.1111/j.1439-0507.2004.00982.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A total of 577 patients with tinea capitis have been diagnosed at the Mycology laboratory of 'A. Sygros' Hospital of Skin and Venereal Diseases, Athens, Greece between 1996 and 2001. From these patients, 100 were immigrants from Balkan, Near East and African countries. The vast majority of the patients (95%) were children, mainly at preschool and school age and only 5% were adults. Zoophilic dermatophytes accounted for 86.5% followed by anthropophilic (12.4%) and geophilic (1.2%) dermatophytes. The majority of anthropophilic infections (59.5%) were recorded in the sub-population of immigrants. Microsporum canis (84.5%) was the main etiologic agent.
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Affiliation(s)
- E Frangoulis
- Mycology laboratory, Hospital of Skin and Venereal Diseases A. Sygros, Athens, Greece.
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Abstract
Zoonoses are diseases that can be transmitted from animals to humans. More than 250 distinct zoonoses have been described in the literature. It is estimated that 56% of United States households contain at least one pet, and although considerable research has been performed regarding the more common household animals including dogs, cats, small birds, and rodents, surprisingly little is known about the zoonotic hazards of owning the more exotic pets. According to the 1997 USPHS/IDSA Report on the Prevention of Opportunistic Infections in Persons Infected with Human Immunodeficiency Virus, the immunocompromised patient should avoid contact with feces-laden soil, litter boxes, reptiles, most pet birds, and any animal less than 6 months old . It has also been documented that because of their inquisitive nature, children are at even higher risk for infection from animals than adolescents or immunocompetent adults. In this article the authors have reviewed the available data regarding hazards associated with the hedgehog, flying squirrel, iguana, chinchilla, and cockatoo. With the growing popularity of such exotic pets, further observation and research is warranted. Physicians need to be aware of the possibility of zoonotic disease related to exotic pet ownership, and they should address this issue when obtaining a history and formulating a differential diagnosis of cutaneous lesions suggestive of such illnesses.
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Affiliation(s)
- Ted Rosen
- Department of Dermatology, Baylor College of Medicine, 2815 Plumb, Houston, 7X 77005, USA.
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