On Monday and Tuesday this week, I was working in the clinic in Port Maria and saw two complications of tinea capitus . The first child I saw on Monday was referred in from another clinic for an I&D of a scalp swelling that was not getting better on oral antibiotics. I sent the child to the A&E for the procedure. When I returned Tuesday, I spoke to the Dr. Mighty of the A&E and she told me when they opened up the swelling several live maggots came out. This she said happens when tinea goes untreated and the necrotic tissue is a source for the maggots. They were treating the child with a power that is cidal to the maggots, in addition to Griseofulvin and shampoos. This was a new one for me.
The second case I saw on Tuesday. A child brought in by his aunt, who had custody of him for most of his life. She said he had scalp lesions for several weeks. When she removed the bandana covering his head, I saw large bald spots that were boggy and oozing. It was a kerion, an inflammatory reaction to tinea. In thirty five years of practice in America I could only recall only one or two cases. I was advised to admit him for oral Griseofulvin, Prednisone, and to have the social worker access his home life.
Both these cases gave me a new respect for possible complications of untreated tinea capitus.
Richard
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