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Dermatomykosen durch Haus- und Nutztiere

Vernachlässigte Infektionen?

Dermatomycoses due to pets and farm animals

Neglected infections?

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Zusammenfassung

Dermatomykosen infolge Kontaktes zu Haus- und Nutztieren betreffen häufig Kinder und junge Erwachsene, hauptsächliche Erreger sind zoophile Dermatophyten. Die meist hochentzündlichen Dermatophytosen der freien Haut und Kopfhaut werden – wie seit Langem bekannt – durch Microsporum canis verursacht. Aufgrund fehlender Meldepflicht in Deutschland hat sich ein nahezu unbemerkter Erregerwandel vollzogen hin zu Infektionen durch zoophile Stämme von Trichophyton interdigitale (früher Trichophyton mentagrophytes) sowie neuerdings auch zu Trichophyton species von Arthroderma benhamiae. Bei letzterem Dermatophyten handelt es sich um die anamorphe Spezies der teleomorphen Art Arthroderma benhamiae, der ursprünglich in Fernost (Japan) beschrieben worden ist. Infektionsquelle für diese Hautpilze sind kleine Nagetiere (insbesondere Meerschweinchen), die von den Eltern der im Nachhinein von der Infektion betroffenen Kinder mit bester Absicht als Haustier in Zoohandlungen gekauft werden, ohne dass ihnen klar ist, dass damit gleichzeitig auch ein relevanter Infektionserreger erworben wird. Die Folge sind hochkontagiöse Dermatophytosen, oft eine ausgeprägte Tinea corporis, nicht selten eine Tinea capitis profunda bis hin zum Kerion Celsi. Weitere Dermatophyten, an die aktuell zu denken ist, sind Trichophyton verrucosum – der Erreger der Kälberflechte – sowie Trichophyton erinacei nach Igelkontakt. Nicht zu vergessen sind jedoch auch Hefepilze, vor allem Malassezia pachydermatis, einziger nichtlipophiler Vertreter der Gattung Malassezia, der vom Hund auf den Menschen übertragen wird. Cryptococcus neoformans hat sein Erregerreservoir ebenfalls im Tier, konkret im Vogelkot, neben pulmonalen und Zentralnervensysteminfektionen sind sekundäre, selten primäre kutane Kryptokokkosen bei meist immunsupprimierten Patienten (HIV/Aids) eine mögliche Folge des Kontaktes zu diesen Tieren.

Abstract

Dermatomycoses due to contact with pets and livestock frequently affect children and young adults. Zoophilic dermatophytes are the main important causative agents. It has long been known that the often high inflammatory dermatophytoses of the skin and the scalp are caused mostly by Microsporum canis. Due to an absence of an obligation for reporting fungal infections of the skin to the Public Health Office in Germany, an unnoticed but significant change in responsible pathogens has occurred. Today an increasing number of infections due to zoophilic strains of Trichophyton interdigitale (formerly Trichophyton mentagrophytes) and Trichophyton species of Arthroderma benhamiae are found. The latter mentioned dermatophyte is the anamorph species of the teleomorph Arthroderma benhamiae, which originally was isolated in the Far East (Japan). Source of infection of these dermatophytes are small rodents, in particular guinea pigs. These animals are bought in pet shops by the parents of those children who later are affected by the fungal infection. The coincidental purchase of the relevant fungal pathogen is not obvious to the parents. As a consequence, highly contagious dermatophytoses occur, often tinea capitis sometimes with kerion formation. Further dermatophytes should be considered as cause of a zoophilic dermatomycosis. Both Trichophyton verrucosum, the cause of the ringworm in cattle, and Trichophyton erinacei following contact to hedgehogs are worthy of note. Yeasts cannot be ignored as cause of dermatomycosis, especially Malassezia pachydermatis, the only non-lipophilic species within the genus Malassezia, which can be transferred from dog to men. Cryptococcus neoformans also comes from animal sources. The mucous yeast occurs in bird’s dropping, and it causes both pulmonary and central nervous system infections, but also primary and secondary cutaneous cryptococcosis in immunocompromised patients (HIV/AIDS) as possible consequence after contact to these animals.

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Danksagung

Die exzellenten makroskopischen Fotografien der Pilzkulturen stammen vom Leipziger Fotografen Uwe Schoßig.

Interessenkonflikt

Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

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  1. Haut- und Laborarzt/Allergologie, Andrologie, Labor für medizinische Mikrobiologie, Partnerschaft Prof. Pietro Nenoff & Dr. Constanze Krüger, Straße des Friedens 8, 04589, Mölbis, Deutschland

    P. Nenoff & C. Krüger

  2. Institut für Medizinische Diagnostik Oderland, Frankfurt (Oder), Deutschland

    W. Handrick

  3. Tierpathologie Dr. Vissiennon, Leipzig, Deutschland

    T. Vissiennon

  4. Hautarztpraxis Leipzig, Leipzig, Deutschland

    K. Wichmann

  5. Universitätsmedizin Berlin - Charité, Konsiliarlabor für Dermatophyten, Berlin, Deutschland

    Y. Gräser

  6. Department of Dermatology and Venerology, University Hospital Lozenetz, Academic Educational Hospital of the Saint Kliment Ohridski University, Medical Faculty, Sofia, Bulgarien

    G. Tchernev

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Nenoff, P., Handrick, W., Krüger, C. et al. Dermatomykosen durch Haus- und Nutztiere. Hautarzt 63, 848–858 (2012). https://doi.org/10.1007/s00105-012-2379-y

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