Abstract

Background: Dermatophilus congolensis, a Gram-positive actinomycete, is a well-known animal pathogen but a rare cause of human skin infections. Human dermatophilosis is an infection associated with tropical environments and animal contact that remains frequently underdiagnosed. Case Presentation: We report a case of recurrent folliculitis in a 34-year-old male Muay Thai fighter returning from Thailand to Spain. The patient presented with pustular lesions on his lower limbs following frequent leg shaving and close physical contact during training. Microbiological culture from skin swabs yielded beta-hemolytic colonies, identified as D. congolensis by MALDI-TOF MS. Identification was confirmed through Whole-Genome Sequencing (WGS), which also revealed an absence of antimicrobial resistance genes. Despite the lack of established EUCAST breakpoints, the isolate showed low MICs for most tested antibiotics. The patient was treated with doxycycline, although clinical follow-up was not possible due to travel. Conclusions: This case highlights D. congolensis as an emerging differential diagnosis for persistent folliculitis in travelers and athletes. Our findings suggest a potential horizontal transmission route through contact sports and fomites (e.g., mats) in high-humidity settings.

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