Trichophyton rubrum-induced Majocchi’s Granuloma in a heart transplant recipient. A therapeutic challenge.

[摘要] Background Solid organ transplant recipients are at an increased risk for infections because of long-term immunosuppression to prevent graft rejection. Fungal infections with dermatophytes are a common cause of cutaneous infections seen in organ transplant recipients and cutaneous dermatophyte infections may progress to Majocchi’s granuloma. Itraconazole is an anti-fungal compound used for the treatment of infections of the skin, nails and mucous membranes.Main observation We report on a heart transplant recipient who developed widespread Trichophyton rubrum infection presenting as Majocchi’s granuloma. Itraconazole treatment was complicated by drug interactions. Tricho­phyton rubrum infection progressed, while itraconazole treatment was varied in dose and delivery form.Conclusions In patients with Trichophyton rubrum infections, refractory to itraconazole treatment, altered drug absorption or drug interactions has to be considered. Careful monitoring and adjustment of itraconazole is of vital importance.

[学科分类] 皮肤病学

[关键词] adverse event;fungal infection;itraconazole;Majocchi's Granuloma;mycosis;Trichophyton rubrum