Emerging Fungal STI: What You Need to Realize About TMVII

A sexually transmitted fungal infection, Trichophyton mentagrophytes genotype VII (TMVII), is gaining attention due to a recent outbreak and its ability to mimic more common skin conditions. This article provides an overview of TMVII, its symptoms, diagnosis, treatment, and prevention, based on the latest medical understanding.

What is TMVII?

TMVII is an emerging dermatophyte strain associated with sexual transmission, particularly among men who have sex with men. Initially identified in travelers returning from Southeast Asia, it has now spread to other regions, including the United States, and Europe.

Symptoms of TMVII

TMVII typically presents as a rash that can appear as “round, coin-like rashes that are red and irritated, sometimes with bumps and pimples on top,” according to the Minnesota Department of Health. The rash can occur on the face, buttocks, genitals, arms, legs, and abdomen. It can lead to scarring and secondary infections if left untreated.

Why is TMVII Difficult to Diagnose?

One of the challenges with TMVII is that it can easily be mistaken for other skin conditions. Experts note that tinea infections, in general, can mimic eczema, psoriasis, and bacterial skin infections. Bacterial folliculitis, in particular, can resemble TMVII when the fungus enters a hair follicle. Syphilis can also present with similar rashes, making it crucial to consider sexually transmitted infections when evaluating a patient with an unusual rash.

Diagnosis and Treatment

Diagnosing TMVII can be complex. While a KOH prep (bedside testing for fungus) can be performed, it isn’t always positive even when fungus is present. Cultures can be collected, but results take time and aren’t always conclusive. Treatment typically involves oral antifungal medications. TMVII is not considered resistant to standard antifungal treatments, but treatment can take several months, especially if the infection has been present for a while or if topical steroids have been used.

Recent Outbreaks and Awareness

In March 2026, Minnesota reported its “largest known outbreak” of TMVII, with more than 30 cases identified. The first U.S. Case was reported in New York City in 2024, and Minnesota’s first case was diagnosed in July 2025. As awareness of TMVII increases, more cases are expected to be diagnosed.

Prevention and Education

Educating individuals about TMVII is key to preventing further outbreaks. Clinicians should consider tinea infections when evaluating genital rashes, even those that are atypical. Discussing sexual health and performing thorough examinations are also crucial. Early treatment and counseling on reducing potential spread during treatment are crucial. There is some suggestion of asymptomatic spread, but this requires further study.

What Clinicians Should Do

Clinicians should remember that tinea can cause rashes in the genital area, and these may be atypical. Asking about sexual history and considering testing for other sexually transmitted infections, including syphilis, is important. Referrals to dermatologists are recommended for atypical or unresponsive rashes.

A hypothesis-generating query of US infectious diseases specialists found that 56% had heard of TMVII and 23% knew how to treat TMVII infections, underscoring a need for increased clinician education.