An African-American child with recurrent tinea capitis has just developed a new area of alopecia after successful treatment several months prior. When prescribing treatment with griseofulvin and selenium shampoo, what else should the clinician do?

An African-American child with recurrent tinea capitis has just developed a new area of alopecia after successful treatment several months prior. When prescribing treatment with griseofulvin and selenium shampoo, what else should the clinician do?

• A. Monitor CBC, LFT, and renal function during therapy
• B. Order oral prednisone daily for 5 to 14 days
• C. Perform fungal cultures on family members and pets
• D. Prescribe oral itraconazole or terbinafine

Answer: (C)

Tinea capitis is highly contagious and can be festering in close contacts or animals, so even after the child is treated, the infection can recur if a source in the household or from pets remains. The best next step is to identify these reservoirs by obtaining fungal cultures from family members and from pets. If anyone or any animal is found to harbor the organism, appropriate treatment or management can be started to break the transmission cycle and prevent reinfection of the child. Routine lab monitoring during griseofulvin therapy isn’t typically required, prednisone isn’t indicated for this condition, and switching to another antifungal isn’t the priority here—the crucial move is uncovering and addressing sources of ongoing transmission.

Tinea capitis is highly contagious and can be festering in close contacts or animals, so even after the child is treated, the infection can recur if a source in the household or from pets remains. The best next step is to identify these reservoirs by obtaining fungal cultures from family members and from pets. If anyone or any animal is found to harbor the organism, appropriate treatment or management can be started to break the transmission cycle and prevent reinfection of the child.

Routine lab monitoring during griseofulvin therapy isn’t typically required, prednisone isn’t indicated for this condition, and switching to another antifungal isn’t the priority here—the crucial move is uncovering and addressing sources of ongoing transmission.