The CDC just reported the first U.S. case of a highly contagious infection

The Centers for Disease Control and Prevention recently announced the first U.S. case of a drug-resistant ringworm infection and it was reportedly discovered in New York City. 

Trichophyton indotineae is a highly transmissible and drug-resistant type of ringworm according to the CDC, and it emerged in South East Asia likely due to anti-fungal overuse. 

The CDC noted that the infection is extremely contagious and known for its widespread inflammation of certain parts of the body that leaves them inflamed and covered in plaque. 

Infections have been reported in Asia, Europe, and Canada but there had never been a case of trichophyton indotineae in the U.S. until earlier this year according to the CDC. 

Two women in New York were found to have been suffering from the drug-resistant form of ringworm after a dermatologist reportedly tried to treat them with oral antifungals.

Worried the infections were trichophyton indotineae, the dermatologist contacted public health officials and skin cultures confirmed both patients had drug-resistant ringworm. 

"My radar went up immediately," explained Dr. Avrom Caplan, a dermatology professor at NYU’s Grossman School of Medicine and the doctor who treated both of the patients. 

Dr. Caplan co-authored the CDC report of his encounter with drug-resistant ringworm in which he detailed how he went about helping both patients and what results from their treatments. 

The first patient was a 28-year-old woman who developed pruritic eruptions throughout her body in the summer of 2021 and had her first consultation in December of 2021 according to the CDC report. 

The woman was in her third trimester of pregnancy at the time and later fully recovered from her infection after a 4-week course of itraconazole, though her case was interesting since both she and her doctors were not sure how she was originally infected with ringworm. 

CNN reporter Jen Christensen noted that Dr. Caplan’s first patient had no international travel history where she could have caught the infection and said that her case could “suggest that there is some community spread in the US.”

Dr. Caplan’s second patient was a 47-year-old that presented with similar symptoms to the first patient but had caught her infection while traveling in Bangladesh in the summer of 2022.  

The CDC report stated that the second patient underwent several treatments to alleviate her symptoms after three visits to an emergency room but her condition did not improve. 

"It is hard to confirm diagnostically, but suspicion can be raised clinically if patients present with widespread, itchy, inflamed scaly plaques over the face, neck, trunk or groin," Caplan explained while discussing his cases according to USA Today. 

The woman was evaluated in December 2022 by dermatologists and received a 4-week course of oral terbinafine with no improvement and then a 4-week course of griseofulvin therapy, which reduced her infection b0 80%. More advanced therapy is now being considered to help her fully recover. 

"Given the ease of transmission between people though, it's highly likely that we will see at least family spread if not other local spread," Caplan said, adding that the infection was not difficult to treat according to USA Today.