May 14-STATEN ISLAND, N.Y. - A pair of women in New York City were identified as two of the first cases of a drug-resistant, highly-contagious skin infection in the United States.
The Centers for Disease Control and Prevention (CDC) said the Trichophyton indotineae strain of ringworm-causing fungus was the culprit of the infection, which can cause rashes and itchy, red skin across the body.
Infections from the resilient strain are common in South Asia but have not been previously detected in the U.S., officials said. The New York City cases resulted in lesions on the neck, abdomen, buttocks and thighs of the two women, ages 28 and 47, according to the CDC.
A city-based dermatologist notified public health officials on Feb. 28, 2023, about a pair of patients with tinea, known as ringworm, who were not responding to certain treatments.
The younger patient had the infection in the summer of 2021 while she was pregnant. She began an oral therapy after giving birth, but her condition did not improve after two weeks of therapy. Soon after, she received a four-week course of itraconazole, used to treat fungal infections, which resolved the rash completely.
The CDC said the woman is continuing to be monitored for a potential resurgence of the infection.
The 47-year-old woman developed a severe rash in summer 2022 during a trip to Bangladesh. She received a topical antifungal and steroid combination of creams while overseas, and multiple other treatments were prescribed when she returned to the U.S. - without success. Most recently, she received a four-week course of griseofulvin, used to handle cases of ringworm, which resulted in around an 80% improvement.
Her family members are undergoing evaluation while they experience similar physical symptoms, the CDC said.
The two women had no link to one another, according to officials. Additionally, the younger woman did not have any travel history.
Ringworm is not caused by a worm, contrary to what its name may suggest. It is a fungal infection that can spread through skin-to-skin contact. The infection's proliferation through South Asia may be partially caused to an overuse of certain medications, enabling the strain to build resilience.
"Health care providers should consider T. indotineae infection in patients with widespread tinea, particularly when eruptions do not improve with first-line topical antifungal agents or oral terbinafine," wrote the CDC.
Dr. Avrom Caplan, who treated one of the patients, told NBC News the fungal infection "is not a widespread problem" in the U.S.
Federal officials previously said another drug-resistant fungus, Candida auris, spread at an "alarming rate" in health-care facilities in the United States between 2020 and 2021. Infection of the fungus can be deadly.
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