Inflammatory Tinea Manuum due to Trichophyton Erinacei from a Hedgehog: A Case Report and Review of the Literature

Case Report

J Bacteriol Mycol. 2017; 4(4): 1057.

Inflammatory Tinea Manuum due to Trichophyton Erinacei from a Hedgehog: A Case Report and Review of the Literature

Hui L¹*, Choo KJL¹, Tan JBX² and Yeo YW¹

¹Department of Dermatology, Singapore General Hospital, Singapore

²Department of Microbiology, Singapore General Hospital, Singapore

*Corresponding author: Laura Hui, Department of Dermatology, Singapore General Hospital, Singapore

Received: September 30, 2017; Accepted: November 16, 2017; Published: November 23, 2017

Abstract

There have been an increasing number of reports of hedgehog related zoonotic diseases, which is reflective of the growing popularity of hedgehogs as exotic household pets. We present a case of an acute inflammatory tinea manuum following a hedgehog prick in a healthy 24-year-old veterinarian assistant. She developed an inflamed erythematous plaque studded with pustules on her left palm initially misdiagnosed as a bacterial infection. Fungal culture of the pustules grew Trichophyton mentagrophytes var erinacei. Her lesion resolved with oral terbinafine for two weeks. We use this case to highlight zoonotic dermatophyte cutaneous infections associated with hedgehogs.

Keywords: Hedgehog; Tinea manuum; Dermatophyte; Zoonoses

Introduction

There have been an increasing number of reports of hedgehog related zoonotic cutaneous diseases, which is reflective of the growing popularity of hedgehogs as exotic household pets. Pricks from the spines of a hedgehog can cause inoculation of dermatophytes, such as Trichophyton erinacei (Trichophyton mentagrophytes var erinacei). The resulting cutaneous infection is typically intensely pruritic and highly inflammatory.

Case Presentation

Our patient is a 24-year-old veterinary assistant who presented with a one week history of an acute onset, persistent and progressively enlarging itchy dermatoses on her left palm after sustaining a prick from a hedgehog (African Pygmy Hedgehog, Atelerix albiventris). The hedgehog had been brought in for veterinary examination after it was found on the road.

Initial treatment by a general practitioner included topical betamethasone dipropionate, and when it had not improved, topical acyclovir was used instead. She also received three days of oral ciprofloxacin and azithromycin. She eventually came to our hospital emergency department when her left hand developed pustules, redness and pain despite her earlier treatment.

Physical examination revealed a localised well demarcated erythematous and oedematous plaque studded with multiple pustules on her left palm (Figure 1). She was afebrile and there was no ascending lymphangitis or palpable lymphadenopathy. No retained quills or foreign bodies were seen.