Abstract
BACKGROUND: With improvements in socioeconomic conditions and public health, kerion-type tinea capitis has become much less common in China. As a result, many pediatricians have limited exposure to this condition, leading to delays in diagnosis and inappropriate treatment. This article presents two cases of kerion-type tinea capitis treated at our hospital, summarizing their clinical manifestations, diagnostic journey, and therapeutic outcomes. We aim to enhance early detection and optimize clinical management by summarizing instructive points from these cases. CASE DESCRIPTION: A 6-year-old girl and an 8-year-old girl were admitted to the hospital. Both patients shared similar clinical presentations, including fever, purulent scalp masses, and localized alopecia. Laboratory tests showed markedly elevated peripheral white blood cell (WBC) and neutrophil counts, as well as increased C-reactive protein (CRP) levels. Initially, both cases were misdiagnosed as bacterial folliculitis and treated with antibiotics, which showed little improvement. Etiological analysis later confirmed infection with Trichophyton (T.) interdigitale in one case and T. tonsurans in the other. Complete resolution was achieved in both patients following antifungal combination therapy with itraconazole (5 mg/kg/day) and terbinafine (125 mg/day). CONCLUSIONS: The diagnosis of purulent scalp lesions in children should include fungal etiologies like kerion, not just bacterial infections. Obtaining a definitive etiological diagnosis through timely testing is imperative for guiding effective antifungal treatment and ensuring a favorable prognosis.