Two cases of highly contagious, drug-resistant ringworm infection have been detected in the US.
The cases were reported to the Centers for Disease Control and Prevention (CDC) in February and shared in a report published on Thursday.
The patients, from New York City, had their first symptoms in 2021 and 2022.
One of the patients carrying the infection was identified as a 47-year-old woman who developed a bad case of ringworm – known as tinea – while travelling in Bangladesh.
A rash had developed across her thighs and buttocks and health officials reported that the severe tinea did not improve after antifungal creams were used.
The woman’s infection was caused by a relatively new species of ringworm-causing fungus called Trichophyton indotineae.
Dr Avrom Caplan, an assistant professor of dermatology at NYU Grossman School of Medicine, who treated the patient and was one of the report’s authors, told NBC News: “My radar went up immediately.”
After the woman returned to the US, she visited the hospital’s emergency ward three times for help. Doctors gave several treatments, typically used for ringworm, but there was no improvement by December.
After many attempts, doctors gave the woman a four-week course of griseofulvin therapy, typically used to treat skin infections such as athlete’s foot and ringworm. But, doctors are still looking into other treatment options.
The woman’s son and husband, who live with her and have had similar rashes, are now undergoing evaluation.
Over the past decade, infections from this drug-resistant fungus have spread rapidly in South Asia, likely driven by overuse of medications to treat them, including topical antifungals and corticosteroids, the CDC report said.
Another case of the skin infection
Another patient, 28, developed the skin infection in 2021 during her third trimester of pregnancy.
She had no underlying medical conditions, no exposure to a person with a similar rash and no international travel history.
The rash was found across the woman’s body, including her neck, abdomen, pubic region and buttocks.
She was later diagnosed with tinea and began oral terbinafine therapy in January 2022 after giving birth to her baby.
However, as the rash did not clear up, the patient was then given itraconazole treatment – an antifungal cream.
The rash resolved after four weeks but continues to be monitored for potential recurrence of the infection.
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What is ringworm, and how is it treated?
According to the NHS, ringworm is a common fungal infection.
The main symptom of the infection is a rash that may look red, silver, or darker than the surrounding skin, depending on your skin tone.
The NHS website also states that the rash can be scaly, dry, swollen or itchy.
Ringworm can be passed on through close contact with:
• A person or animal that is already infected
• Objects that are harbouring the infection, such as bedsheets, combs or towels
• Soil containing the infection, although the NHS has said this is less common
The CDC has said that treatments for ringworm depend entirely on its location on the body and how serious the infection is.
Some forms of ringworm can be treated with over-the-counter drugs, while others may need treatment with prescription anti-fungal medication.