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Presumptive Zoonotic Kerion by Nannizzia gypsea: Case Report
Deborah Cruciani1, Manuela Papini2, Sayra Broccatelli1,3
1Centro Specialistico Patologie Micotiche, Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche "Togo Rosati", Perugia, Italy.
Abstract:
Nannizzia gypsea (formerly Microsporum gypseum) belongs to geophilic dermatophytes, fungi involved in keratin degradation in the soil; however, they are also found in dogs and cats. Transmission to humans can occur directly by contact with soil, but indirect transmission via domestic animals is reported too. The exact source of the infection is usually difficult to assess and in most cases only hypothesised and rarely investigated. This case report describes a kerion caused by N. gypsea in a 2-year-old boy, where the contagion was probably secondary to domestic healthy carrier dogs. A "One-Health" approach involving human dermatologists and veterinarians, combined with the use of conventional and molecular-based techniques, allowed tracing of the epidemiological chain and managing of not only the treatment but also the prevention of a recurrence. The child's lesion began to regress after about 8 weeks of treatment with both systemic and topical therapy, while the dogs were given chlorhexidine and miconazole baths. No recurrences nor new infections occurred, demonstrating the effectiveness of the strategies used.
Insights
Nannizzia gypsea, a soil fungus, caused a scalp infection (kerion) in a child, likely from household dogs. A One Health approach successfully treated the child and dogs, preventing reinfection.
Area of Science:
- Mycology
- Dermatology
- Veterinary Medicine
- Epidemiology
Background:
- Nannizzia gypsea (formerly Microsporum gypseum) is a geophilic dermatophyte found in soil, dogs, and cats.
- Human infections can result from direct soil contact or indirect transmission via domestic animals.
- Identifying the exact source of Nannizzia gypsea infections is often challenging.
Observation:
- A case report details a kerion (scalp inflammation) in a 2-year-old boy caused by Nannizzia gypsea.
- The infection was likely transmitted from healthy carrier dogs within the household.
- The child presented with a fungal lesion on the scalp.
Findings:
- A "One Health" strategy, integrating human and veterinary medicine with molecular techniques, traced the infection's origin.
- The child received systemic and topical treatment, with lesion regression observed within 8 weeks.
- Affected dogs were treated with chlorhexidine and miconazole baths, and no recurrences were noted in the household.
Implications:
- This case highlights the importance of considering domestic animals as reservoirs for geophilic dermatophytes.
- Integrated "One Health" approaches are effective for diagnosing, managing, and preventing zoonotic fungal infections.
- Successful management involved combined therapeutic strategies for both the human patient and animal contacts.
