Presumptive Zoonotic Kerion by Nannizzia gypsea: Case Report

Abstract

Nannizzia gypsea (formerly Microsporum gypseum) belongs to geophilic dermatophytes, fungi involved in keratin degradation in the soil; however, they are also found in dogs and cats. Transmission to humans can occur directly by contact with soil, but indirect transmission via domestic animals is reported too. The exact source of the infection is usually difficult to assess and in most cases only hypothesised and rarely investigated. This case report describes a kerion caused by N. gypsea in a 2-year-old boy, where the contagion was probably secondary to domestic healthy carrier dogs. A "One-Health" approach involving human dermatologists and veterinarians, combined with the use of conventional and molecular-based techniques, allowed tracing of the epidemiological chain and managing of not only the treatment but also the prevention of a recurrence. The child's lesion began to regress after about 8 weeks of treatment with both systemic and topical therapy, while the dogs were given chlorhexidine and miconazole baths. No recurrences nor new infections occurred, demonstrating the effectiveness of the strategies used.

Keywords: Nannizzia gypsea; case report; child; dog; kerion.

Figure 1

Child's scalp lesion, showing hair loss, pus discharge and crusting.

Figure 2

Culture examination. (A) Macroscopic appearance of the colonies; (B) reverse of the macroscopic colonies; (C) microscopic view of Nannizzia gypsea, showing hyaline, multiseptate and fusiform thin-walled macroconidia (methylene blue stain, × 100, bar 10 μm).

Figure 3

Clinical course. (A) Three months and (B) 4 months after initiation of treatment.