Romero F A, Deziel P J, Razonable R R
Division of Infectious Diseases and the William J von Liebig Transplant Center, Mayo Clinic, Rochester, Minnesota 55905, USA.
Transpl Infect Dis. 2011 Aug;13(4):424-32. doi: 10.1111/j.1399-3062.2010.00596.x. Epub 2011 Jan 27.
Superficial fungal infections are fairly prevalent in transplant recipients and the incidence increases with more intense graft-conserving immunosuppressive therapy. Majocchi's granuloma is a deep folliculitis caused by dermatophytes that involves deeper layers of the dermis. Only a few case reports of the condition have been documented in transplant recipients. After an extensive review of the medical literature, 21 cases were retrieved and are summarized here, together with a new case that occurred in a recent heart transplant recipient from our institution. This report aims to provide a comprehensive analysis of Majocchi's granuloma in solid organ transplant (SOT) recipients, with special focus on potential risk factors, offending pathogens, clinical presentation, therapeutic approaches, and outcome. General observations are presented emphasizing the relevance of close clinical and dermatologic follow-up in high-risk SOT patients with specific comments regarding treatment regimens and outcomes.
浅表真菌感染在移植受者中相当普遍,且随着更强化的保留移植物免疫抑制治疗,其发病率会增加。Majocchi 肉芽肿是一种由皮肤癣菌引起的深部毛囊炎,累及真皮深层。在移植受者中,仅有少数关于该病症的病例报告。在广泛查阅医学文献后,检索到 21 例病例并在此进行总结,同时还包括我们机构近期一名心脏移植受者发生的一例新病例。本报告旨在对实体器官移植(SOT)受者中的 Majocchi 肉芽肿进行全面分析,特别关注潜在危险因素、致病病原体、临床表现、治疗方法及预后。文中给出了一般性观察结果,强调了对高危 SOT 患者进行密切临床和皮肤科随访的重要性,并对治疗方案及预后给出了具体评论。