Department of Dermatology, Hangzhou Third Hospital, Zhejiang University of Traditional Chinese Medicine, Hangzhou, 310009, People's Republic of China.
BMC Infect Dis. 2019 Mar 20;19(1):271. doi: 10.1186/s12879-019-3897-3.
Dermatophytes are keratinophilic fungi, that usually infect the hair, stratum corneum, and nails. However, dermatophytes occasionally invade the dermis, subcutaneous tissues, and internal organs, resulting in a condition called deep dermatophytosis. We report a case of an unusual presentation of Trichophyton rubrum infection causing multiple fungal abscesses in the lower extremities of an immunocompromised patient.
A 66-year-old male who had been receiving immunosuppressive drugs for 7 years developed numerous subcutaneous nodules in the lower extremities. The yellow purulent fluid obtained from the cyst was positive for T. rubrum. Topical bifonazole cream was effective for tinea pedis, but oral Sporanox 400 mg/day was discontinued after 2 months because the patient died from pneumonia after hospitalization for a lumbar fracture.
Although deep dermatophytosis is very rare, dermatomycosis should be considered in any examination of patients who are receiving immunosuppressive drugs. Fungi can enter the bloodstream and disseminate to distant major organs, including the lymph nodes, liver, brain, and bone, which often causes systemic infections that can be fatal.
皮肤癣菌是亲角质的真菌，通常感染毛发、角质层和指甲。然而，皮肤癣菌偶尔会侵犯真皮、皮下组织和内脏器官，导致一种称为深部皮肤癣菌病的疾病。我们报告一例罕见的红色毛癣菌感染表现为免疫功能低下患者下肢多发性真菌性脓肿。
一名 66 岁男性，因接受免疫抑制药物治疗已 7 年，下肢出现多个皮下结节。从囊肿中获得的黄色脓性液体对红色毛癣菌呈阳性。外用联苯苄唑乳膏对足癣有效，但口服斯皮仁诺 400mg/天在 2 个月后因患者因腰椎骨折住院后肺炎死亡而停药。
虽然深部皮肤癣菌病非常罕见，但接受免疫抑制药物治疗的患者任何检查都应考虑皮肤癣菌病。真菌可以进入血液并播散到远处的主要器官，包括淋巴结、肝脏、大脑和骨骼，这通常会导致全身感染，可能致命。
