In older children and adults, it's known that the background T. tonsurans carriage rate is low, around 5%. Symptoms occur at the time the fungal infection is acquired. Isolation of symptomatic patients and treatment with antifungal agents are routine.
The picture in preschoolers described by Dr. Abdel-Rahman and colleagues was quite dissimilar. They documented a high background colonization rate, ranging from 14% to 44% on a monthly basis. Symptomatic disease occurred at any time, not in conjunction with acquisition of infection or particular strain types.
The investigators identified three carriage patterns. Most common was persistent carriage of a single exclusive strain. Another common pattern was carriage of a predominant strain month after month, with transient appearance of additional strains.
Least common was carriage of random strains. Symptomatic disease appeared to represent activation of a single persistent strain present on a child's scalp (Pediatrics 2006;118:2365-73).
“If you're in preschool, it's a different illness,” Dr. Radetsky observed. “It is chronic background colonization with periodic symptomatic disease that gets better on its own and may not even require isolation.”
'This is it. No further information will ever come out in the future that will help you' in decision making. DR. RADETSKY