DESCRIPTIONS OF MEDICAL FUNGI

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194 Descriptions of Medical Fungi Trichophyton Malmsten Rippon (1988) accepted 22 species and four varieties in the genus Trichophyton based on morphology. DNA sequences now play a prominent role in delineating phylogenetic relationships, and as such species concepts in Trichophyton have changed. Sixteen species are now recognised in the genus. The descriptions and species concepts provided in this publication are based upon a combination of traditional morphological criteria and the current (2016) recognised phylogenetic species (de Hoog et al. 2016). The genus Trichophyton is characterised morphologically by the development of both smooth-walled macro- and microconidia. Macroconidia are mostly borne laterally directly on the hyphae or on short pedicels, and are thin- or thick-walled, clavate to fusiform, and range from 4-8 x 8-50 µm in size. Macroconidia are few or absent in many species. Microconidia are spherical, pyriform to clavate or of irregular shape and range from 2-3 x 2-4 µm in size. The presence of microconidia differentiates this genus from Epidermophyton, and the smooth-walled, mostly sessile macroconidia differentiates it from Lophophyton, Microsporum and Nannizzia. In practice, two groups may be recognised on direct microscopy: 1. Those species that usually produce microconidia; macroconidia may or may not be present i.e. T. rubrum, T. interdigitale, T. mentagrophytes, T. equinum, T. eriotrephon, T. tonsurans, and to a lesser extent T. verrucosum, which may produce conidia on some media. In these species the shape, size and arrangement of the microconidia is the most important character. Culture characteristics are also useful. 2. Those species that usually do not produce conidia. Chlamydospores or other hyphal structures may be present, but microscopy is generally non-diagnostic; i.e. T. verrucosum, T. violaceum, T. concentricum, T. schoenleinii and T. soudanense. Culture characteristics and clinical information such as the site, appearance of the lesion, geographic location, travel history, animal contacts and even occupation are most important. Many laboratories have used growth on additional media and/or confirmatory tests to help differentiate between species of Trichophyton, especially isolates of T. rubrum, T. interdigitale, T. mentagrophytes and T. tonsurans. These include growth characteristics on media such as Littman oxgall agar, lactritmel agar, potato dextrose agar, Sabouraud’s agar with 5% Salt, 1% peptone agar, bromocresol purple-milk solids glucose agar (BCP), Trichophyton agars No. 1-5, hydrolysis of urea and hair perforation tests. Molecular Identification: ITS and EF-1α sequencing is recommended for accurate species identification (Gräser et al. 1998, 1999b, 2000a, 2008; Irinyi et al. 2015; Mirhendi et al. 2015). MALDI-T<strong>OF</strong> MS: Methods reported by Erhard et al. (2008), Nenoff et al. (2011), Cassange et al. (2011), l’Ollivier et al. (2013), Calderaro et al. (2014), Packeu et al. (2013, 2014). References: Rebell and Taplin (1970), Ajello (1972), Vanbreusegham et al. (1978), Rippon (1988), McGinnis (1980), Domsch et al. (1980), Kane et al. (1997), Chen et al. (2011), de Hoog et al. (2000, 2015, 2016).
Descriptions of Medical Fungi 195 Trichophyton concentricum is an anthropophilic fungus which causes chronic widespread non-inflammatory tinea corporis known as tinea imbricata because of the concentric rings of scaling it produces. It is not known to invade hair. Infections among Europeans are rare. Distribution is restricted to the Pacific Islands of Oceania, South East Asia and Central and South America. RG-2 organism. Morphological Description: Colonies are slow growing, raised and folded, glabrous becoming suede-like, mostly white to cream-coloured, but sometimes orange-brown coloured, often deeply folded into the agar which may produce splitting of the medium in some cultures. Reverse is buff to yellow-brown to brown in colour. Cultures consist of broad, much-branched, irregular, often segmented, septate hyphae which may have “antler” tips resembling T. schoenleinii. Chlamydospores are often present in older cultures. Microconidia and macroconidia are not usually produced, although some isolates will produce occasional clavate to pyriform microconidia. Note: Hyphal segments may artificially resemble macroconidia. Confirmatory Tests: Trichophyton concentricum Blanchard Hydrolysis of Urea: Negative after 7 days. Vitamin Free Agar (Trichophyton Agar No.1): Growth occurs on vitamin free agar (T1) but is usually slightly better on media containing thiamine i.e. T3 = T1 + thiamine and inositol, and T4 = T1 + thiamine. The slight enhancement of growth in the presence of thiamine helps to distinguish T. concentricum from T. schoenleinii, although this does not occur in all strains. Hair Perforation Test: Negative at 28 days. Key Features: Clinical disease, geographical distribution and culture characteristics. a b 20 µm Trichophyton concentricum (a) culture showing a typical slow growing, heaped and folded, glabrous to suede like colony, and (b) the formation of typical “balloon-shaped” chlamydospores. Note: Microconidia and macroconidia are usually not produced.
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DESCRIPTIONS OF MEDICAL FUNGI

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