Tinea capitis, caused by Microsporum canis (felineum) : literature review and clinical cases

Abstract

According to statistics, tinea capitis remains the main mycological problem in childhood. The spectrum of causative agents of tinea capitis varies depending on the continent. In epidemiological terms, the pathogenic fungus Microsporum canis (felineum)absolutely predominates on the Eurasian continent.

A significant problem in the diagnosis and, in particular, in the treatment of microsporia are cases of the disease in very young children: we estimate this most problematic age from 1 to 18 months. Microsporia in children under the age of 1 year is the most relevant in pediatric clinical mycology due to the limited arsenal of topical and systemic medications approved at this age.

The clinical case presented in this article demonstrates an example of successful treatment of scalp microsporia in a 7-month-old child who had contraindications to systemic therapy. It should be noted that the duration of treatment in this case was almost 4 months, while the most effective therapy regimens, including systemic drugs, lead to the elimination of pathogenic fungus from the foci on the scalp within 30–45 days.

Keywords

microsporia / microsporia in children under 1 year of age / systemic and topical therapy of mycoses

References

[1] Mycoses of the scalp, trunk, hands and feet. Clinical recommendations. State Moscow: Research Center of Dermatovenereology and Cosmetology; 2020. (In Russ).

[2] Микозы кожи головы, туловища, кистей и стоп. Клинические рекомендации. Москва: Государственный научный центр дерматовенерологии и косметологии, 2020.

[3] Medvedeva TV, Leina LM, Chilina GA, et al. Microsporia: Current understanding of the problem (description of clinical cases and literature review). Problems Medical Mycology. 2020;22(2):12–21. EDN: BDVCVW doi: 10.24412/1999-6780-2020-2-12-21

[4] Медведева Т.В., Леина Л.М., Чилина Г.А., и др. Микроспория: современное представление о проблеме (описание клинических случаев и обзор литературы) // Проблемы медицинской микологии. 2020. Т. 22, № 2. С. 12–21. EDN: BDVCVW doi: 10.24412/1999-6780-2020-2-12-21

[5] Moskaluk AE, VandeWoude S. Current topics in dermatophyte classification and clinical diagnosis. Pathogens. 2022;11(9):957. EDN: TNMKUT doi: 10.3390/pathogens11090957

[6] Moskaluk A.E., Vande Woude S. Current topics in dermatophyte classification and clinical diagnosis // Pathogens. 2022. Vol. 11, N 9. P. 957. EDN: TNMKUT doi: 10.3390/pathogens11090957

[7] Wang T, Chen JQ. Tinea capitis due to Microsporum canis. N Engl J Med. 2021;385(22):2077. doi: 10.1056/NEJMicm2108047

[8] Wang T., Chen J.Q. Tinea capitis due to microsporum canis // N Engl J Med. 2021. Vol. 385, N 22. P. 2077. doi: 10.1056/NEJMicm2108047

[9] Khamaganova IV, Maksimova MV, Lytkina EA. Features of the course of microsporia at the present time. Adv Med Mycol. 2019;(20):83–84. (In Russ). EDN: ZSGFFR

[10] Хамаганова И.В., Максимова М.В., Лыткина Е.А. Особенности течения микроспории в настоящее время // Успехи медицинской микологии. 2019. № 20. С. 83–84. EDN: ZSGFFR

[11] Xia X. Family outbreak of Microsporum canis infection. QJM. 2022;115(10):679–680. EDN: OIWTNI doi: 10.1093/qjmed/hcac170

[12] Xia X. Family outbreak of Microsporum canis infection // QJM. 2022. Vol. 115, N 10. P. 679–680. EDN: OIWTNI doi: 10.1093/qjmed/hcac170

[13] Aneke CI, Rhimi W, Hubka V, et al. Virulence and antifungal susceptibility of Microsporum canis strains from animals and humans. Antibiotics (Basel). 2021;10(3):296. doi: 10.3390/antibiotics10030296

[14] Aneke C.I., Rhimi W., Hubka V., et al. Virulence and antifungal susceptibility of Microsporum canis strains from animals and humans // Antibiotics (Basel). 2021. Vol. 10, N 3. P. 296. doi: 10.3390/antibiotics10030296

[15] Weary PE, Canby CM, Cawley EP. Keratinolytic activity of Microsporum canis and Microsporum gypseum. J Invest Dermatol. 1965;44:300–310. doi: 10.1038/jid.1965.54

[16] Weary P.E., Canby C.M., Cawley E.P. Keratinolytic activity of Microsporum canis and Microsporum gypseum // J Invest Dermatol. 1965. Vol. 44. P. 300–310. doi: 10.1038/jid.1965.54

[17] Ramos ML, Coelho RA, Brito-Santos F, et al. Comparative analysis of putative virulence-associated factors of Microsporum canis isolates from human and animal patients. Mycopathologia. 2020;185(4):665–673. doi: 10.1007/s11046-020-00470-9

[18] Ramos M.L., Coelho R.A., Brito-Santos F., et al. Comparative analysis of putative virulence-associated factors of Microsporum canis isolates from human and animal patients // Mycopathologia. 2020. Vol. 185, N 4. P. 665–673. doi: 10.1007/s11046-020-00470-9

[19] Ciesielska A, Kawa A, Kanarek K, et al. Metabolomic analysis of Trichophyton rubrum and Microsporum canis during keratin degradation. Sci Rep. 2021;11(1):3959. EDN: IJKLJF doi: 10.1038/s41598-021-83632-z

[20] Ciesielska A., Kawa A., Kanarek K., et al. Metabolomic analysis of Trichophyton rubrum and Microsporum canis during keratin degradation // Sci Rep. 2021. Vol. 11, N 1. P. 3959. EDN: IJKLJF doi: 10.1038/s41598-021-83632-z

[21] Tikhonovskaya IV, Adaskevich VP, Shafranskaya TV. Microsporia in children: Clinic, diagnosis and treatment. Retsept. 2006;(3):72–74. (In Russ). EDN: QZLQYH

[22] Тихоновская И.В., Адаскевич В.П., Шафранская Т.В. Микроспория у детей: клиника, диагностика и лечение // Рецепт. 2006. № 3. С. 72–74. EDN: QZLQYH

[23] Aste N, Pinna AL, Pau M, Biggio P. Kerion celsi in a newborn due to Microsporum canis. Mycoses. 2004;47(5-6):236–237. EDN: FPAIUL doi: 10.1111/j.1439-0507.2004.00967.x

[24] Aste N., Pinna A.L., Pau M., Biggio P. Kerion celsi in a newborn due to Microsporum canis // Mycoses. 2004. Vol. 47, N 5-6. P. 236–237. EDN: FPAIUL doi: 10.1111/j.1439-0507.2004.00967.x

[25] Shimoyama H, Taira H, Satoh K, et al. Kerion celsi due to Microsporum canis in an adult woman, treated successfully with fosravuconazole. Med Mycol J. 2023;64(2):37–43. EDN: AHLLLV doi: 10.3314/mmj.22-00025

[26] Shimoyama H., Taira H., Satoh K., et al. Kerion celsi due to Microsporum canis in an adult woman, treated successfully with fosravuconazole // Med Mycol J. 2023. Vol. 64, N 2. P. 37–43. EDN: AHLLLV doi: 10.3314/mmj.22-00025

[27] Berg JC, Hamacher KL, Roberts GD. Pseudomycetoma caused by Microsporum canis in an immunosuppressed patient: A case report and review of the literature. J Cutan Pathol. 2007;34(5):431–434. doi: 10.1111/j.1600-0560.2006.00628.x

[28] Berg J.C., Hamacher K.L., Roberts G.D. Pseudomycetoma caused by Microsporum canis in an immunosuppressed patient: A case report and review of the literature // J Cutan Pathol. 2007. Vol. 34, N 5. P. 431–434. doi: 10.1111/j.1600-0560.2006.00628.x

[29] Yang X, Shi X, Chen W, et al. First report of kerion (tinea capitis) caused by combined Trichophyton mentagrophytes and Microsporum canis. Med Mycol Case Rep. 2020;29:5–7. doi: 10.1016/j.mmcr.2020.05.002

[30] Yang X., Shi X., Chen W., et al. First report of kerion (tinea capitis) caused by combined Trichophyton mentagrophytes and Microsporum canis // Med Mycol Case Rep. 2020. Vol. 29. P. 5–7. doi: 10.1016/j.mmcr.2020.05.002

[31] Kharisova AR, Hismatullina ZR. Atypical forms of microsporia. In: Fundamental and applied aspects of modern infectology: Collection of scientific articles by participants of the all-Russian scientific and practical conference on May 18–19, 2017. Ufa: Research Center for Information and Legal Technologies; 2017. Р. 98–100. (In Russ). EDN: ZCYMAB

[32] Харисова А.Р., Хисматуллина З.Р. Атипичные формы микроспории // Фундаментальные и прикладные аспекты современной инфектологии: сборник научных статей участников Всероссийской научно-практической конференции 18–19 мая 2017 г. Уфа: Исследовательский центр информационно-правовых технологий, 2017. С. 98–100. EDN: ZCYMAB

[33] Vislobokov AV, Khmelnitsky RA. Microsporia: Diagnostic difficulties. Russ J Skin Venereal Dis. 2010;2():47–49. (In Russ). EDN: MSOBXL

[34] Вислобоков А.В., Хмельницкий Р.А. Микроспория: трудности диагностики // Российский журнал кожных и венерических болезней. 2010. № 2. С. 47–49. EDN: MSOBXL

[35] Patent RUS № RU 2643408 C1. Ufimtseva MA, Antonova SB, Golubkova AA, et al. A method for differential diagnosis of microsporia of smooth skin and pink lichen in children. (In Russ). Available from: https://yandex.ru/patents/doc/RU2643408C1_20180201?ysclid=lzjppnwto2379587479. Accessed: 15.04.2024.

[36] Патент на изобретение RU 2643408 C1. Уфимцева М.А., Антонова С.Б., Голубкова А.А., и др. Способ дифференциальной диагностики микроспории гладкой кожи и розового лишая Жибера у детей. Режим доступа: https://yandex.ru/patents/doc/RU2643408C1_20180201?ysclid=lzjppnwto2379587479. Дата обращения: 15.04.2024.

[37] Lavrushko SI, Stepanenko VI. Modern diagnosis and complex treatment of microspore in athletes. East Eur Sci J. 2021;2(8):9–15. doi: 10.31618/ESSA.2782-1994.2021.2.72.112

[38] Lavrushko S.I., Stepanenko V.I. Modern diagnosis and complex treatment of microspore in athletes // East Eur Sci J. 2021. Vol. 2, N 8. P. 9–15. doi: 10.31618/ESSA.2782-1994.2021.2.72.112

[39] Zou X, Chen W, Li R. Neonatal-onset inflammatory tinea capitis by Microsporum canis due to a woolen hat. Mycopathologia. 2023;188(5):585–587. EDN: WFVNNB doi: 10.1007/s11046-022-00699-6

[40] Zou X., Chen W., Li R. Neonatal-onset inflammatory tinea capitis by Microsporum canis due to a woolen hat // Mycopathologia. 2023. Vol. 188, N 5. P. 585–587. EDN: WFVNNB doi: 10.1007/s11046-022-00699-6

[41] Ginter G. Microsporum canis infections in children: Results of a new oral antifungal therapy. Mycoses. 1996;39(7-8):265–269. doi: 10.1111/j.1439-0507.1996.tb00136.x

[42] Ginter G. Microsporum canis infections in children: Results of a new oral antifungal therapy // Mycoses. 1996. Vol. 39, N 7-8. P. 265–269. doi: 10.1111/j.1439-0507.1996.tb00136.x

[43] Xiao YY, Zhou YB, Chao JJ, Ma L. Successful treatment of tinea capitis caused by Microsporum canis in a 23-day-old newborn with itraconazole pulse therapy and a review of the literature. Dermatol Ther. 2021;34(5):e15078. doi: 10.1111/dth.15078

[44] Xiao Y.Y., Zhou Y.B., Chao J.J., Ma L. Successful treatment of tinea capitis caused by Microsporum canis in a 23-day-old newborn with itraconazole pulse therapy and a review of the literature // Dermatol Ther. 2021. Vol. 34, N 5. P. e15078. doi: 10.1111/dth.15078

[45] Le TK, Cohen BA. Tinea capitis: Advances and a needed paradigm shift. Curr Opin Pediatr. 2021;33(4):387–391. doi: 10.1097/MOP.0000000000001034

[46] Le T.K., Cohen B.A. Tinea capitis: Advances and a needed paradigm shift // Curr Opin Pediatr. 2021. Vol. 33, N 4. P. 387–391. doi: 10.1097/MOP.0000000000001034

[47] Glotova TI, Chugunova TB, Panova NE. Features of the treatment of cats with microsporia. In: Current problems of veterinary medicine, animal husbandry, commodity science, social studies and personnel training in the Southern Urals at the turn of the century: Materials of the international scientific-practical and methodological conference. Troitsk; 2000. P. 23–24. (In Russ). EDN: FIRTOO

[48] Глотова Т.И., Тугунова Т.Б., Панова Н.Е. Особенности лечения кошек, больных микроспорией // Актуальные проблемы ветеринарной медицины, животноводства, товароведения, обществознания и подготовки кадров на Южном Урале на рубеже веков: материалы международной научно-практической и методической конференции. Троицк, 2000. С. 23–24. EDN: FIRTOO

[49] Zaslavsky DV, Murashkin NN, Knyazev AS, Materikin AI. Features of the course and therapy of microsporia in children. In: St. Petersburg Dermatological readings: Materials of the 4th Russian Scientific and Practical Conference. Saint Petersburg; 2010. P. 65. (In Russ). EDN: XWUJZR

[50] Заславский Д.В., Мурашкин Н.Н., Князев А.С., Материкин А.И. Особенности течения и терапии микроспории у детей // Санкт-Петербургские дерматологические чтения: материалы 4-й Российской научно-практической конференции. Санкт-Петербург, 2010. С. 65. EDN: XWUJZR

[51] Kano R, Watanabe M, Tsuchihashi H, et al. Antifungal susceptibility testing for Microsporum canis from cats in Japan. Med Mycol J. 2023;64(1):19–22. EDN: GWDHRU doi: 10.3314/mmj.22-00014

[52] Kano R., Watanabe M., Tsuchihashi H., et al. Antifungal susceptibility testing for Microsporum canis from cats in Japan // Med Mycol J. 2023. Vol. 64, N 1. P. 19–22. EDN: GWDHRU doi: 10.3314/mmj.22-00014

[53] Yakovlev AB, Polonskaya AS, Kruglova LS. Microsporia in young children: Clinical cases. Curr Pediatrics. 2022;21(5):400–406. EDN: QCWRFF doi: 10.15690/vsp.v21i5.2453

[54] Яковлев А.Б., Полонская А.С., Круглова Л.С. Микроспория у детей раннего возраста: клинические случаи // Вопросы современной педиатрии. 2022. Т. 21, № 5. С. 400–406. EDN: QCWRFF doi: 10.15690/vsp.v21i5.2453

[55] Ginter-Hanselmayer G, Seebacher C. Treatment of tinea capitis: A critical appraisal. J Dtsch Dermatol Ges. 2011;9(2):109–114. EDN: OMQTDP doi: 10.1111/j.1610-0387.2010.07554.x

[56] Ginter-Hanselmayer G., Seebacher C. Treatment of tinea capitis: A critical appraisal // J Dtsch Dermatol Ges. 2011. Vol. 9, N 2. P. 109–114. EDN: OMQTDP doi: 10.1111/j.1610-0387.2010.07554.x

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