Wisconsin DHS Health Alert #70: Trichophyton mentagrophytes Genotype VII (TMVII): Clinical Awareness and Regional Update
Bureau of Communicable Diseases
March 6, 2026
Key points
- Trichophyton mentagrophytes type VII (TMVII), is an emerging dermatophyte (ringworm) with evidence of transmission through close skin-to-skin contact, including sexual contact.
- A cluster of more than 30 confirmed or suspected TMVII cases has been identified in Minnesota since July 2025.
- At this time, the Wisconsin Department of Health Services (DHS) is not aware of confirmed cases in Wisconsin; however, visibility is limited because TMVII is not a reportable condition in Wisconsin and routine surveillance mechanisms do not apply.
- Clinicians should consider TMVII in patients presenting with persistent, painful, or atypical genital, perianal, buttock, thigh, or facial dermatophyte infections, particularly when lesions may clinically overlap with syphilis or other sexually transmitted infections.
- Early recognition, appropriate systemic treatment, and collaboration between clinicians and public health are important to identify and manage potential cases. Clinicians should contact the Sexually Transmitted Infection (STI) Unit at DHS for assistance with diagnostic testing and reporting suspected or confirmed cases to the new Trichophyton mentagrophytes genotype VII (TMVII) registry established by the CDC (Centers for Disease Control and Prevention).
Background
Trichophyton mentagrophytes genotype VII (TMVII) is a recently recognized dermatophyte fungus that causes tinea (ringworm). In June 2024, the CDC reported the first U.S. case of genital ringworm caused by TMVII. Since that time, sporadic cases have been identified in multiple states.
Minnesota has identified more than 30 confirmed or suspected cases since July 2025, representing the largest known cluster in the United States to date. Reported cases have disproportionately involved men who have sex with men (MSM), and many have been associated with close skin-to-skin contact during sexual activity. Refer to the Minnesota Department of Health health advisory for additional details. TMVII is not classified as a sexually transmitted infection (STI). However, epidemiologic patterns suggest transmission may occur during sexual contact.
Because TMVII is not reportable in Wisconsin, DHS does not have the same level of surveillance visibility that exists for reportable STIs such as syphilis, gonorrhea, or HIV. Awareness among clinicians is therefore essential for early identification and appropriate management.
Clinical presentation
TMVII infection may present with:
- Inflamed, itchy, painful, or persistent skin lesions.
- Sharply demarcated, erythematous, scaly plaques.
- Papules or pustules.
- Lesions involving the genitals, perianal region, buttocks, thighs, abdomen, beard area, or face.
Lesions may resemble primary or secondary syphilis, mpox, eczema, or other dermatologic conditions. Co-infections with STIs have been reported. Because syphilis remains prevalent in Wisconsin and is reportable, clinicians should include syphilis in the differential diagnosis when evaluating compatible rashes and perform appropriate STI testing when indicated.
Detailed descriptions of previous cases with photographs of characteristic lesions have been published in the Morbidity and Mortality Weekly Report (MMWR) and the CDC's Emerging Infectious Diseases journal.
Diagnosis
Clinicians should suspect dermatophyte infection based on clinical appearance and history. If TMVII is suspected:
- Confirm dermatophyte infection with potassium hydroxide (KOH) microscopy when available.
- Obtain fungal culture from skin scrapings or biopsy.
- Identification of TMVII specifically requires genotyping of a fungal isolate and is not included in routine dermatophyte testing panels.
- Genotype confirmation is available through select national reference laboratories when specifically requested, often ordered as a miscellaneous or send-out test. Clinicians should consult their laboratory test directory or contact their laboratory medical director regarding specimen collection and ordering procedures.
- Clinicians who need assistance identifying testing pathways may contact DHS.
Treatment
If TMVII infection is suspected, initiate empiric oral terbinafine 250 mg daily. Do not delay treatment while awaiting culture or genotyping results. Treatment generally lasts 6–8 weeks and may require longer duration based on clinical response. Treatment should be continued until there is complete clinical resolution topical corticosteroids should be avoided, as they may worsen dermatophyte infection.
Sincerely,
Ryan Westergaard, MD, PhD, MPH
Chief Medical Officer and State Epidemiologist
Bureau of Communicable Diseases
Division of Public Health
Wisconsin Department of Health Services
Resources
- Suspected or confirmed cases of TMVII may be reported to the CDC through the Trichophyton mentagrophytes genotype VII (TMVII) registry.
- This registry assists the CDC in gaining a comprehensive understanding of TMVII’s spread in the United States and understand it’s impact on affected populations.
- The form should only be filled out by clinical providers or public health professionals.
- Clinical consultations with CDC subject matter experts are available, if needed. Health care providers can call 404-639-5168 or email fungalconsult@cdc.gov for consultation on diagnosis or treatment for suspected or confirmed fungal diseases.
- Syphilis is a reportable disease and should be reported to the local health department of the address of the patient. For more information on reporting syphilis in Wisconsin, visit the DHS STI Unit webpage for health care professionals.
Questions
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