Li Jing, Song Yinggai, Liu Xiao, Pan Jing
Department of Dermatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, People's Republic of China.
Fourth Medical College of Peking University, Beijing, People's Republic of China.
Clin Cosmet Investig Dermatol. 2025 May 17;18:1213-1218. doi: 10.2147/CCID.S520618. eCollection 2025.
and are rare pathogens that cause chronic cutaneous and soft tissue infections. Although molecular technologies have improved their diagnosis, both diseases are challenging to treat. Here, we describe the first case of cutaneous granuloma caused by concurrent and infections.
A 67-year-old male patient presented with a one-year history of painful erythematous nodules on his left ring finger after a fish stabbing. He was apparently immunocompetent and received no immunosuppressive treatment. Histopathological examination revealed infectious granuloma. Positive cultures for mycobacteria and fungi, along with molecular testing, confirmed the mixed infection with and . Considering his old age and hepatitis B core antibody, we initiated treatment with oral clarithromycin, topical sulfadiazine silver cream (SSC), and topical nifuratel nystatin gel (NNG). Owing to adverse events, the course of clarithromycin was limited to ten days. Nonetheless, a three-month regimen of continuous topical SSC and NNG led to the complete recovery of his lesions without recurrence.
This is the first reported case of mixed infection with and . The combination therapy with 10-day oral clarithromycin treatment and 3-month topical SSC and NNG successfully treated superficial infections caused by these two distinct pathogens. This case could offer a viable alternative for patients unable to endure prolonged systemic therapy. Further studies are required to verify its efficacy.
[病原体名称1]和[病原体名称2]是引起慢性皮肤和软组织感染的罕见病原体。尽管分子技术已改善了它们的诊断，但这两种疾病的治疗都具有挑战性。在此，我们描述了首例由[病原体名称1]和[病原体名称2]同时感染引起的皮肤肉芽肿病例。
一名67岁男性患者在被鱼刺伤后，左手无名指出现疼痛性红斑结节，病史长达一年。他免疫功能正常，未接受免疫抑制治疗。组织病理学检查显示为感染性肉芽肿。分枝杆菌和真菌培养阳性，以及分子检测，证实了[病原体名称1]和[病原体名称2]的混合感染。考虑到他的年龄和乙肝核心抗体情况，我们开始用口服克拉霉素、外用磺胺嘧啶银乳膏（SSC）和外用硝呋太尔制霉菌素凝胶（NNG）进行治疗。由于出现不良事件，克拉霉素疗程限制为10天。尽管如此，连续外用SSC和NNG三个月的疗程使他的皮损完全恢复且无复发。
这是首例报告的[病原体名称1]和[病原体名称2]混合感染病例。10天口服克拉霉素治疗与3个月外用SSC和NNG的联合疗法成功治疗了由这两种不同病原体引起的浅表感染。该病例可为无法耐受长期全身治疗的患者提供一种可行的替代方案。需要进一步研究以验证其疗效。
