Infections with Trichophyton mentagrophytes genotype VII, colloquially known as the "Thailand fungus", are spreading in Europe. Early and correct treatment is particularly important for this stubborn and very painful skin fungus. How can you protect yourself and how is it treated?
The most important facts in brief
- Trichophyton mentagrophytes VII causes an unpleasant ringworm with large, suppurating pustules.
- While in the past it was mainly travelers returning from South Asia who were affected, there has been an increase in infections within Switzerland in recent years.
- It is important to react quickly to symptoms in order to receive adequate treatment and prevent the spread of the disease.
It begins with itching, redness or scaling, often in the genital area or on the trunk, followed by purulent and very painful skin lesions: The skin fungus known as Trichophyton mentagrophytes genotype VII (or Trichophyton mentagrophytes VIIfor short) causes an unpleasant ringworm (medically known as tinea corporis). Originally transmitted to humans by animals, people are now infected with the highly contagious pathogen mainly through sexual contact, but also when traveling.
The “Thailand mushroom”
Trichophyton mentagrophytes VII is also known colloquially as the “Thailand fungus”. This is due to the fact that the first cases of infection in Europe were detected in travelers returning from Thailand. However, most infections with the skin fungus now take place within national borders. As the fungus is mainly transmitted through sexual contact and primarily manifests itself in the genital area, it is now also referred to as “penis fungus”, especially in tabloid media.
“Around 10 years ago, we were the first to identify and publish sexual transmission with skin fungi. Those most affected were travelers returning from South Asia, especially Thailand.”
“We are a long way from a pandemic.”
“Around 10 years ago, we were the first to identify and publish sexual transmission with skin fungi. Those affected were mainly travelers returning from South Asia, especially Thailand, who had had sexual contact there – a kind of travel souvenir,” says Philipp Bosshard, senior assistant at the Dermatology Clinic of the USZ. “For a few years now, however, we have been seeing an increase in infections within Switzerland.” The pathogen has therefore been in the headlines repeatedly in recent weeks. Bosshard, who as an expert on fungal skin infections has a good overview of the situation, puts things into perspective: “We do regularly see patients with an infection, but we wouldn’t talk about a “rapid spread”, as some newspapers are calling it. We are a long way from a pandemic.”
However, it is important that people are made aware of this fungal disease and react quickly when symptoms occur in order to receive adequate treatment and prevent it from spreading.
How do I know if I am infected?
“In general, fungal skin infections can be misdiagnosed or overlooked,” says Bosshard, who, as a fungal skin specialist at the USZ, is often consulted in cases where the infection is already well advanced. “With this infection, redness or scaling of the skin on the trunk and in the genital area usually occurs first. Only then can the purulent pustules typical of this fungus appear,” the specialist continues. “These are then often mistaken for a bacterial infection and treated with antibiotics – which of course don’t work.”
The following symptoms indicate an infection with Trichophyton mentagrophytes VII:
- circular redness and scaly patches of skin in the genital area, on the trunk, buttocks or face
- Large, suppurating pustules
- Fistulas and abscesses
- swollen lymph nodes
- Fever
The same applies to this fungus: the earlier it is treated, the easier the therapy. “That’s why people who notice a skin change should always see a dermatologist as soon as possible so that a correct diagnosis can be made.” Nowadays, initial diagnoses can also be made online. The USZ, for example, offers a teledermatology service where you can simply send in pictures of the affected areas of skin and receive a diagnosis shortly afterwards.
How is Trichophyton mentagrophytes VII treated?
In the case of the “Thailand fungus”, superficial treatment with ointments or creams, as is usual with most other skin fungi, is usually not sufficient. “Trichophyton mentagrophytes VII often causes a severely inflamed infection that extends into the deeper layers of the skin,” explains Bosshard. This is why the fungus is usually treated with tablets. “Unfortunately, treatment with antifungals is somewhat protracted,” says the skin fungus expert. “It often lasts 6-8 weeks, and some sufferers have to take medication for several months.”
But there is also good news: “So far, there has been no resistance to the common drugs. This means that treatment is generally successful, even if it takes a long time.” In addition, an infection is not life-threatening and the fungus does not affect any organs.
Trichophyton mentagrophytes genotype VIII
Another closely related skin fungus is Trichophyton mentagrophytes VIII, also known as Trichophyton indotineae. This fungus has caused a veritable epidemic in India and elsewhere, often infecting entire families. Cases have been registered worldwide for a few years now. One of the first cases in Europe was found in the dermatology clinic’s laboratory back in 2014. Typically, the trunk, buttocks, inguinal region, legs or face are also affected. The fungus is transmitted through direct skin contact or by sharing towels etc. In contrast to Trichophyton mentagrophytes VII, Trichophyton mentagrophytes VIII is usually resistant to the standard antifungal medication and patients often have to be treated with other antifungal tablets for several months.
How can I protect myself?
Since Trichophyton mentagrophytes VII is transmitted particularly effectively during sexual intercourse, the most effective protective measure is to refrain from sexual activity if there are skin lesions in the genital area. “In addition, shaving in the genital area appears to increase the risk of becoming infected with the fungus,” says Bosshard. This can be explained by the fact that shaving causes micro-lesions, i.e. tiny injuries, which favor infections with the pathogen. “If you suspect you have a skin infection, stop shaving and see a specialist instead,” advises Bosshard.
Contaminated bed linen and hand or bath towels can also lead to infection. “In such a case, the laundry should be washed at 60°C,” says the expert. Here too, however, he emphasizes the importance of taking symptoms seriously and seeking help as quickly as possible. “But that,” he adds, “actually applies to all health problems that suddenly arise.”
