Needless to say, we’re all pulling through somehow. The weather has been glorious and it’s now the official school summer holidays. Homeschooling has been somewhat of an education to all of us at home. The older kids have learnt to cook and prepare their own lunches and we’ve all had to have our own share of housework (though a house cleaned by children for 3 months may not be Insta-worthy!).
Us grown ups have had to help and partake in this homeschooling experience, particularly so for our youngest child and especially for the more practical aspects. One such Engineering project was to research a wildlife habitat for an animal that frequented our garden and then construct the thing. I’m afraid our imaginations only stretched to a hedgehog and once the thing was built, it has been left rather neglected at the back of the garden for whatever animal potters there, hedgehog or no.
And luckily none of us touched the thing if we had found it. The June edition of Clinical and Experimental Dermatology reports an Australian case report of fungal infection of the hand secondary to handling a hedgehog.
[De Brito M, Halliday C, Dutta B et al. A prickly souvenir from a hedgehog café: tinea manuum secondary to Tricophyton erinacei via international spread. Clin Exp Dermatol 2020: 45;459-61.]
What did the case report?
The case involved a 40-year old lady who had visited a hedgehog and fox café in Japan 2 months earlier.
What did her skin problem look like?
She presented with a 2-week history of a blistering plaque on the palm of the left hand. It was reported as red-looking originally, then developed vesicles (or small blisters) and then developed pus. It was reported as quite severely painful, itchy and swollen.
The history could be in keeping with a type of eczema and it was initially treated as such.
What investigations are needed to diagnose the fungal infection?
She had bacterial and viral swabs performed which were negative. A skin biopsy was performed which showed the presence of fungi under the microscope but unfortunately, culture of the skin for fungus was negative.
However, polymerase chain reaction (PCR) testing for the fungus showed positivity for Tricophyton erinacei DNA. She was treated as such with almost complete resolution. She was left with some faint redness of the palm and some residual tingling pain for several weeks.
Is this common?
According to my local vet, fungal infection of hedghehogs is extremely common and they would not recommend handling them without wearing thick gloves.
Looking at the literature, Tricophyton erinacei is an emerging pathogen. It is reported in the literature primarily after contact with hedgehogs, primarily pet hedgehogs and especially in Japan where they have become increasingly popular to have as a pet. It is rarely an organism found on humans.
[Abarca ML, Castellá G, Martorell J et al. Tricophyton erinacei in pet hedgehogs in Spain: Occurrence and revision of taxonomic status. Med Mycol 2017;55:164-172.]
[Tsuchihashi H, Hiruma M et al. Tinea Corporis Due to Tricophyton erinacei Probably Transmitted from a Hedgehog. Kim J, Med Mycol J 2018; 59:E77-E79.]
[Kromer C, Nenoff P, Uhrlaß S et al. Tricophyton erinacei Transmitted to a Pregnant Woman From Her Pet Hedgehogs. JAMA Dermatol 2018;154:967-68.]
Take home points?
Be careful when handling hedgehogs if you find them in the garden and wear protective gloves if you do. In this era where more exotic pets are desired by some, they may still carry organisms or pathogens we are only just becoming aware of.
Kind regards,
Sandy
Dr Sandy Flann, Consultant Dermatologist.
