The dermatophytes

Chapter 38


The dermatophytes


The dermatophytes are a group of closely related, septate fungi that require and use keratin for growth. They tend to be confined to the superficial integument including the outer stratum corneum of the skin, nails, claws and hair of animals and man. The classical lesions are circular and known as ringworm. Traditionally the dermatophytes are placed in the Deuteromycota or Fungi Imperfecti in three anamorphic (asexual or imperfect state) genera: Microsporum, Trichophyton and Epidermophyton. However, the teleomorphic (perfect or sexual) state has been described for some and they are classified in the genus Arthroderma, phylum Ascomycota.


Over 30 species of dermatophytes are known. Those affecting animals are placed in one of two genera, Microsporum or Trichophyton. Epidermophyton floccosum is principally a human pathogen. The dermatophyte species affecting animals are described as ectothrix as the septate hyphae invading the skin and hairs fragment into arthrospores and these form a sheath around the infected structures. Macroconidia and microconidia are produced in the non-parasitic state in laboratory cultures. The Microsporum species tend to produce spindle (Fig. 38.1) or boat-shaped (Fig. 38.2) macroconidia whereas those of the Trichophyton species are usually elongated, cigar-shaped with almost parallel sides (Fig. 38.3). The macroconidia of M. nanum are unique in being round and usually two-celled (Fig. 38.4). Figure 38.5 gives the main points of differentiation between the two genera. The colonies of many of the dermatophytes are pigmented and both the obverse and reverse of the colonies should be examined to assist identification.









Natural Habitat


The geophilic (soil-loving) dermatophytes inhabit the soil and can exist there as free-living saprophytes. Microsporum gypseum and M. nanum are examples of geophilic dermatophytes that can also cause lesions in animals and in man. The zoophilic dermatophytes are obligate pathogens, primarily parasitizing animals but also capable of infecting humans. Humans are the main host for the anthropophilic dermatophytes and these very rarely cause ringworm in animals and are not considered in this chapter. Some dermatophytes have become adapted for survival in the skin of specific host animals, for example:



These dermatophytes generally give rise to subclinical or inapparent infections in the host animal, although they can also produce clinical lesions. Zoophilic species tend to be associated with a particular animal species. However, infection can also occur from reservoirs such as rodents (T. mentagrophytes), hedgehogs (T. erinacei; Fig. 38.6), soil (M. gypseum) and fomites such as bedding, grooming gear and harness containing hairs with infective arthrospores. Whilst growing on keratinized structures these fungi rarely produce macroconidia and rely instead on the production of arthrospores for transmission from host to host. Arthrospores can remain viable on shed hairs and skin particles for at least six to 12 months. The reservoir, transmission and site of the lesions can often be related to the actual dermatophyte involved. This is especially evident in the horse and the dog and is an argument in favour of attempting to isolate and identify the dermatophyte in an infection. Table 38.1 lists the main dermatophytes affecting animals, the main hosts of each and their geographical distribution.





Pathogenesis


Infective arthrospores germinate within six hours of adhering to keratinized structures. Minor trauma of the skin and dampness may facilitate infection. The ability of the dermatophytes to hydrolyse keratin causes damage to the epidermis, hair shafts, hair follicles and feathers. The nature of the lesions is affected by the virulence of the fungus and the immunological response of the host. Very young and very old animals as well as debilitated or immunosuppressed individuals are most susceptible to infection. The host mounts an inflammatory response to the fungal metabolic products that is harmful to the fungus, so the dermatophyte moves away peripherally towards normal skin. The result is the commonly seen circular lesions (ringworm) of alopecia with healing at the centre and inflammation at the edge (Fig. 38.7). There appears to be a balanced host–parasite relationship where a dermatophyte has become adapted to a specific host animal. While these animals may not show lesions they can act as a reservoir of infection. The manifestations of dermatophyte infections can vary and may be summarized as:





Laboratory Diagnosis



Preliminary examination: Wood’s lamp


Microsporum canis, M. canis var. distortum, M. audouinii (human) and M. ferrugineum (human) produce certain metabolites when growing on hairs and skin that will fluoresce a vivid apple-green under the ultraviolet light of a Wood’s lamp. The animal itself can be examined with the lamp in a dark room and the site of the lesions will fluoresce. The technique is particularly useful for suspected inapparent infections in kittens that almost always involve M. canis. The infected areas are often the face, front paws and abdominal area of these kittens. Alternatively, the lamp can be used to examine plucked hairs or skin scrapings taken from lesions. It is estimated that about 50% of M. canis infections give this fluorescence, so negative cases should always be submitted for further laboratory examinations. If a topical ointment has been applied to the lesion, this can sometimes lead to spurious fluorescence.

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Jul 18, 2016 | Posted by in PHARMACOLOGY, TOXICOLOGY & THERAPEUTICS | Comments Off on The dermatophytes

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