Department of Nephrology, Erciyes University Medical Faculty, Köşk Distinct, Dede Efendi Street, 38039, Melikgazi, Kayseri, Turkey.
Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey.
CEN Case Rep. 2024 Dec;13(6):552-556. doi: 10.1007/s13730-024-00883-1. Epub 2024 May 20.
Kidney transplantation is the encouraged kidney replacement therapy due to providing more prolonged survival with a better quality of life. Unfortunately, kidney transplant recipients are susceptible to infections because of long-term utilization of immunosuppression. Despite dermatophyte infections are generally not life-threatening, the clinical significance has been recently enhanced by an increasing number of immunocompromised patients. We have presented a rare dermatophytosis course, Majocchi's granuloma, that spreads to all extremities during the early post-transplant period. A young kidney transplant recipient was exposed to intensive immunosuppression therapy due to acute rejection in the early period of post-transplantation. After four months, numerous nodular skin lesions were raised on various body parts. An invasive fungal infection was identified in the skin biopsy. Also, Trichophyton rubrum was isolated in the tissue cultures. Consequently, the patient was diagnosed with Majocchi's granuloma. An effectual treatment was attained with an oral terbinafine tablet. Majocchi's granuloma is a distinct form of dermatophytosis characterized by the spreading of infection into the dermis. In this unexpected case, we alerted physicians to opportunistic infections in the kidney transplant recipient.
肾移植是鼓励采用的肾脏替代治疗方法,因为它能提供更长的生存时间和更好的生活质量。不幸的是,由于长期使用免疫抑制剂,肾移植受者易发生感染。尽管皮肤癣菌感染一般不会危及生命,但由于免疫功能低下患者的数量不断增加,其临床意义最近有所增强。我们报告了一例罕见的皮肤癣菌病病程,即 Majocchi 肉芽肿,它在移植后早期扩散到所有四肢。一名年轻的肾移植受者因移植后早期急性排斥反应而接受强化免疫抑制治疗。四个月后,身体各部位出现了许多结节性皮肤病变。皮肤活检发现侵袭性真菌感染。此外,在组织培养中分离出红色毛癣菌。因此,该患者被诊断为 Majocchi 肉芽肿。口服特比萘芬片取得了良好的治疗效果。Majocchi 肉芽肿是一种特殊形式的皮肤癣菌病,其特征是感染扩散到真皮。在这个意外的病例中,我们提醒医生注意肾移植受者中的机会性感染。