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What to know about rare sexually transmitted fungal infection TMVII

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6 months ago

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What to know about rare sexually transmitted fungal infection TMVII

A rare sexually transmitted fungus has been in the news recently after it was reported for the first time in the U.S.

The first U.S. case of Trichophyton mentagrophytes type VII, or TMVII for short, involved a man in his 30s from New York City who developed ringworm (tinea) on his genitals, buttocks and limbs after he reported having sex with men during a trip to California and trips overseas to England and Greece, according to USA Today.

When the man returned home, according to the case study, he developed an itchy, red rash on areas including his groin, genitals and buttocks, and tests confirmed he had contracted the rare fungus.

Though there have been few cases of TMVII worldwide — one in the United States and 13 in France, mainly among men who have sex with men, though it can affect anyone — news of the sexually transmitted fungus made many fear a repeat of the 2022 mpox outbreak. Mpox is a virus that is spread through sexual contact and disproportionately has affected men who have sex with men.

“It’s not concerning yet, but it’s something to be aware of,” Dr. Jason Halperin, DAP Health’s director of Specialty Programs, said of TMVII.

Here’s what you need to know.

What is Trichophyton mentagrophytes type VII?

TMVII is in the tinea family. Its appearance can be compared to ringworm, because the infection could look like it’s in a ring formation, and jock itch, due to a red, itchy rash that appears around the genitals or rectum.

It is spread through rigorous skin-to-skin contact. Most reported cases so far has been associated with sexual contact, but that doesn’t have to be the only form of transmission. For example, ringworm if often transmitted through wrestling.

TMVII is not a new infection, Halperin said, but this strain is more difficult to treat. A topical treatment that might normally be used for two to three weeks may now need to be used for three to four months until symptoms clear.

It’s also important to note that TMVII is not a systemic infection, such as mpox, but rather a topical infection. That means a patient will not see “any severe outcomes” from this type of infection, outside of irritation and a change in the look of skin, Halperin said.

Though a majority of cases thus far have been among men who have sex with men, Halperin stressed that this sexually transmitted fungus can be spread to anyone, regardless of gender or sexual preference.

What are the symptoms?

Symptoms of TMVII infection include:

  • A large, red, itchy, scaly rash that can appear in ring-like patterns
  • A rash around genitals, buttocks and legs, but could also be presented on other parts of the body
  • In some cases, the affected skin may blister, crack or ooze

Is it similar to mpox or syphilis?

There are a few similarities between TMVII, mpox and syphilis.

Mpox can be spread through close contact with skin lesions or bodily fluids of infected animals or humans (alive or dead), including droplets. The virus can also be spread through sexual contact. Mpox can infect anyone, but it has disproportionately affected men who have sex with men.

Symptoms start within three weeks of exposure and include fever, headache, muscle aches, swollen lymph nodes, rash and lesions often in the genital and perianal region. Illness typically lasts for two to four weeks.

Halperin said the rash or lesions associated with mpox are “typically much more painful” compared to TMVII, which is more itchy.

Syphilis is a bacterial sexually transmitted infection that, if left untreated, can lead to serious health issues, the World Health Organization states. It is transmitted during oral, vaginal and anal sex, in pregnancy and through blood transfusion.

Halperin said people with syphilis can present it in many different ways, but most typically there is a painless, red, crusted lesion usually located in the place of inoculation, which can be the genitals, rectum or oral areas. It tends to not be painful nor itchy. If untreated, the lesions fade away and the patient goes into a latent phase.

“That latent phase is so important that people get regular testing because you can transmit in that latent phase even though there’s no symptoms,” Halperin said.

Without treatment, the tertiary phase of syphilis may lead to several health complications decades after infection and can affect multiple organs and systems, including the brain, nerves, eyes, liver, heart, blood vessels, bones and joints, according to the World Health Organization. Tertiary syphilis can also cause death.

Preventative measures are currently available for both mpox and syphilis infections. The two-dose Jynneos vaccine is available to help prevent mpox and lessen symptoms in people who have been exposed to the virus. Additionally, DoxyPEP is a post-exposure preventative treatment for syphilis, chlamydia and gonorrhea that can reduce infections up to 70%.

“We’re recognizing after mpox that we need to be vigilant, we need to be on the lookout,” Halperin said.

I see a new rash on my body. What should I do?

Halperin said anyone who develops a rash around their genitals or rectum should contact their health care provider for an evaluation to determine if they have been affected by TMVII or another infection.

What tips should I keep in mind?

As people mix and mingle this summer, Halperin reminds everyone to engage in healthy communication with all sexual partners, be mindful of any changes on their bodies and to not have any shame if they need to see a medical provider for an evaluation.

Additionally, those who are sexually active should get tested regularly for STIs, vaccinated against mpox if they are at high-risk of infection and take preventative medication for HIV (PrEP) and bacterial sexually transmitted infections (specifically syphilis, chlamydia and gonorrhea) if engaging in unprotected sex. Use condoms or other barrier methods during vaginal, oral or anal sex to protect against STIs.

“The greatest driver of sexually transmitted infections is stigma,” Halperin said. “If we all commit to regular testing and taking medications that lower that risk, we would see dramatic decreases.”

USA Today contributed to this report.

Ema Sasic covers entertainment and health in the Coachella Valley. Reach her at ema.sasic@desertsun.com or on Twitter @ema_sasic.

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