A preschool child presented with a three-day history of painless, non-pruritic pustules on the right palm. Exam showed erythema with vesicles and pustules localized to the ulnar aspect of the palm. Bacterial culture of pustule fluid was negative, while fungal culture was positive for Trichophyton mentagrophytes. Direct microscopic examination of skin scrapings revealed abundant fungal hyphae. A fur sample from the family rabbit yielded the same fungal species on culture. A diagnosis of inflammatory (dermatophytic) tinea manuum was made. Context: T. mentagrophytes is a common dermatophyte causing dermatophytosis, with global prevalence estimated around 25%, higher in tropical and subtropical areas. Rodents and rabbits are primary reservoir hosts for zoophilic T. mentagrophytes. In this case, exposure to a pet rabbit correlated with infection. Notes: The report highlights that zoophilic dermatophyte infections can present with pustular, inflammatory lesions on the hands and may involve direct contact with animal reservoirs. The fungal etiology was established by positive culture and microscopically visible hyphae; bacterial etiology was effectively ruled out by negative culture.
A preschool child presented with a three day history of painless, non-pruritic pustules on her right palm (fig1). She was otherwise well, with no relevant medical history. The family reported keeping a pet rabbit at home.bmj;393/apr02_9/e086736/F1F1f1Fig 1Physical examination showed erythema, vesicles, and pustules localised to the ulnar aspect of the right palm. Bacterial culture of the pustule fluid showed negative results, whereas the results of the fungal culture were positive for Trichophyton mentagrophytes. Direct microscopic examination of skin scrapings showed abundant fungal hyphae. A fur sample taken from the rabbit was positive for the same fungal species when tested with a fungal culture.A diagnosis of inflammatory tinea manuum was made.T. mentagrophytes is a common causative pathogen in dermatophytosis, which affects about 25% of the global population, with markedly higher prevalence in tropical and subtropical regions.1Rodents and rabbits serve as primary reservoir hosts for zoophilic T. mentagrophytes. When humans are infected,...