Updated August 1, 2025
NCCID Disease Debriefs provide Canadian public health practitioners and clinicians with up-to-date reviews of essential information on prominent infectious diseases for Canadian public health practice. While not a formal literature review, information is gathered from key sources including the Public Health Agency of Canada (PHAC), the USA Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and peer-reviewed literature.
This disease debrief was prepared and updated by Samiksha Ghimire. Questions, comments, and suggestions regarding this disease brief are most welcome and can be sent to nccid@manitoba.ca
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Questions Addressed in this debrief:
- What are important characteristics of TMVII?
- What is happening with current outbreaks of TMVII?
- What is the current risk for Canadians from TMVII?
- What measures should be taken for a suspected TMVII case or contact?
What are important characteristics of TMVII?
Cause
Trichophyton mentagrophytes genotype VII (TMVII) is an emerging dermatophyte that primarily spreads through direct contact with an infected host. This fungal pathogen is known for causing dermatophytosis, particularly affecting the skin, hair and nails.
TMVII transmission occurs through direct skin-to-skin contact, including through sexual contact. Additionally, the fungus can spread via contaminated surfaces, clothing, or animal contact. Men who have sex with men have been identified as a key risk group in current outbreaks.
Trichophyton mentagrophytes Genotype VII- Centre for Disease Prevention and Control
Signs and Symptoms
Infections caused by TMVII present distinct dermatological symptoms, including lesions that can appear on the genitals, buttocks, face, trunk, arms, hands, and legs. A characteristic ringworm rash often develops, marked by a circular, red, and scaly appearance. The affected areas may be itchy, develop blisters, and appear discoloured compared to the surrounding skin. In some cases, the infection may resemble psoriasis or eczema, leading to potential misdiagnosis. Persistent lesions can cause chronic skin irritation and discomfort.
Trichophyton mentagrophytes Genotype VII- Centre for Disease Prevention and Control
Severity and Complications
Infections can vary in severity: some cases resolve with treatment, while others lead to complications even with treatment. In severe cases, prolonged infection could result in scarring. Additionally, open sores or blistered areas increase the risk of secondary bacterial infections. If left untreated, persistent lesions can cause significant inflammation, leading to chronic skin irritation and discomfort.
Trichophyton mentagrophytes Genotype VII- Centre for Disease Prevention and Control
Epidemiology
Men who have sex with men (MSM) are currently identified as a high-risk group due to documented clusters of transmission in this population. Since March 2021, 32 cases of TMVII infections have been identified in France, all occurring in men. In the USA, four cases were reported between April and July 2024, all in cisgender men aged 30–39 years. No cases have been reported in Canada to date.
U.S. authorities warn about an emerging sexually transmitted fungus – CATIE
Laboratory Diagnosis
A preliminary diagnosis of TMVII is based on clinical signs and symptoms, including characteristic dermatological lesions. For laboratory confirmation, a skin sample is taken from the affected area and examined under a microscope to identify fungal elements. A fungal culture is then performed to isolate the pathogen, and DNA sequencing is used to confirm the presence of Trichophyton mentagrophytes genotype VII (TMVII).
Trichophyton mentagrophytes Genotype VII- Centre for Disease Prevention and Control
Sexually Transmitted Fungal Infection (TMVII)- Cleveland Clinic
Transmission
TMVII spreads primarily through direct skin-to-skin contact, including sexual contact. Indirect transmission can occur via contaminated objects such as towels, bedding, and clothing. Additionally, TMVII can be transmitted from animals to humans, making zoonotic exposure a potential risk factor.
Trichophyton mentagrophytes Genotype VII- Centre for Disease Prevention and Control
Sexually Transmitted Fungal Infection (TMVII)- Cleveland Clinic
Prevention and Control
To prevent TMVII infection, individuals should maintain good hygiene by regularly washing and thoroughly drying their skin. Avoiding direct skin-to-skin contact with affected areas and refraining from sharing personal items (such as towels, bedding, and clothing) until symptoms have resolved can help reduce the risk of transmission. Topical corticosteroid products should be avoided, as they can worsen the infection.
Trichophyton mentagrophytes Genotype VII- Centre for Disease Prevention and Control
Vaccination
Currently, there is no vaccine available for TMVII.
Treatment
Empiric therapy for TMVII should be initiated due to the time required for laboratory confirmation. Oral antifungal medications such as terbinafine or itraconazole are commonly prescribed, with topical antifungal treatments suitable for mild infections. For persistent or extensive cases, a combination of oral and topical therapies is recommended. Patients should be aware of possible side effects, including gastrointestinal upset, headache, skin rashes, and, in rare cases, liver toxicity. Regular monitoring may be necessary, especially during prolonged use of systemic antifungals. Completing the full course of treatment is essential to prevent recurrence. Corticosteroids should be avoided, as they can suppress the immune response, potentially worsening the infection and masking symptoms.
Trichophyton mentagrophytes Genotype VII- Centre for Disease Prevention and Control
Sexually Transmitted Fungal Infection (TMVII)- Cleveland Clinic
What is happening with current outbreaks of TMVII?
In France between 2023-2024, 32 cases of TMVII were reported, primarily among men who have sex with men (MSM). Among these cases, thirteen were identified in men aged 22–59 years, seven of whom were living with HIV. Five of the HIV-negative individuals affected were taking PrEP. A significant outbreak was associated with a masseur, with 15 clients and his roommate connected to the transmission.
In the United States, the first known case was identified in June 2024, in a man who had recently traveled to Europe and California. Since then, four cases have been reported, all in cisgender men aged 30–39 years.
As of February 2024, no cases have been reported in Canada.
U.S. authorities warn about an emerging sexually transmitted fungus – Catie
Trichophyton mentagrophytes Genotype VII- Centre for Disease Prevention and Control
Sexually Transmitted Fungal Infection (TMVII)- Cleveland Clinic
What is the current risk for Canadians from TMVII?
As of February 2024, there have been no reported cases of TMVII in Canada. However, its emergence in other countries highlights the importance of public awareness and the need for preventive measures to reduce potential for transmission. While the overall risk to the general population remains low, certain groups may face a slightly elevated risk. In particular, men who have sex with men appear to be more affected in current outbreaks, making targeted education and prevention strategies especially important for this population.
U.S. authorities warn about an emerging sexually transmitted fungus – Catie
Diseases and conditions- Government of Canada
What measures should be taken for a suspected TMVII case or contact?
Although TMVII is not currently a notifiable disease, providers should stay informed on evolving public health guidelines, especially if clusters emerge in higher-risk populations. If TMVII infection is suspected, healthcare providers should consider empiric antifungal treatment based on clinical presentation, particularly in cases of topical treatment failure, highly inflammatory lesions, or anogenital involvement. Patients should be advised to avoid direct skin-to-skin contact with affected areas and refrain from sharing personal items like towels, clothing, and bedding until symptoms resolve.
Trichophyton mentagrophytes Genotype VII- Centre for Disease Prevention and Control
U.S. authorities warn about an emerging sexually transmitted fungus – Catie