title: The man who got too close to his cows.
abstract: Trichophyton verrucosum is one of the more common chronic zoophilic dermatophytes. Its presentation is diverse, including aggressive inflammatory skin lesions, and it can be accompanied by constitutional symptoms, such as fever and lymphadenopathy. As such, it may be misdiagnosed as bacterial cellulitis and undergo multiple antibiotic courses unsuccessfully, without consideration of a fungal skin infection. We present a cattle farmer presenting with an extensive erythematous plaque that failed to respond to antibacterial treatment. History revealed that his cows were being treated for "ringworm". His diagnosis was confirmed by skin biopsy demonstrating fungal elements and culture yielding T. verrucosum. The farmer was successfully treated with itraconazole.
authors.affiliation: Department of Dermatology, University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada.
authors.forename: Shane
authors.initials: S
authors.lastname: Silver
authors.forename: Donald C
authors.initials: DC
authors.lastname: Vinh
authors.forename: John M
authors.initials: JM
authors.lastname: Embil
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000935:Antifungal Agents / Q000627:therapeutic use; D001706:Biopsy; D002417:Cattle; D003937:Diagnosis, Differential; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000382:microbiology / Q000473:pathology; D014005:Tinea / Q000382:microbiology*; D014249:Trichophyton / Q000302:isolation & purification*; D015047:Zoonoses / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D017964:Itraconazole