Inflammatory tinea pedis/manuum masquerading as bacterial cellulitis

Sweeney SM, Wiss K, Mallory SB.Department of Medicine, Division of Dermatology, University of Massachusetts Medical School, Worchester 01605, USA.
sweeneys@ummhc.org

BACKGROUND: Tinea pedis and tinea manuum in children are more common than previously recognized. Clinical presentations of dermatophyte infections may vary in children and may be difficult to diagnose.

OBJECTIVE: To show the necessity of potassium hydroxide preparations and/or fungal cultures in assessing suspicious cases of cellulitis in children who may have dermatophyte infections. PATIENTS: We describe 4 children with inflammatory tinea pedis or tinea manuum who were initially misdiagnosed as having bacterial cellulitis.

INTERVENTION: A potassium hydroxide examination was performed on 3 patients. Fungal cultures were performed on 2 patients.

RESULTS: Inflammatory/bullous dermatophyte infections were detected by potassium hydroxide examination in all 4 patients and all 4 children successfully responded to topical antifungal therapy.

CONCLUSIONS: These cases demonstrate that inflammatory tinnea pedis/manuum can masquerade as cellulitis in children. Early potassium hydroxide examination can allow appropriate antifungal treatment to be initiated before fungal culture results are finalized.

PMID: 12413346 [PubMed - indexed for MEDLINE]

Related Abstracts

The necessity of culture for the diagnosis of tinea pedis.

Ecemis T, Degerli K, Aktas E, Teker A, Ozbakkaloglu B.Celal Bayar University, Faculty of Medicine, Department of Microbiology and Clinical Microbiology, Manisa, Turkey. talat.ecemis@bayar.edy

BACKGROUND: This study examined the consistency between the clinical diagnosis of tinea pedis and the results of direct fungal examination, prepared with 10% potassium hydroxide, and culture.

METHODS: 2,427 patients clinically diagnosed with tinea pedis who presented to the mycology laboratory were reviewed retrospectively for the outcomes of direct fungal examination and culture.

RESULTS: Direct examination was positive in 54.3% and culture was positive in 36.6% of the cases. The sensitivity and specificity of direct microscopy were 95.7% and 69.6%, respectively

CONCLUSIONS: The clinical diagnosis of tinea pedis can be misleading, since it features lesions that can also be present in some other skin diseases and direct microscopy may be insufficient to confirm the diagnosis. Therefore, we suggest using culture for a definitive diagnosis.

PMID: 16479181 [PubMed - indexed for MEDLINE]

See also:

Bullous tinea pedis in two children.

Dermatophyte infections.