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


Steiner, Urs C; Trüeb, Ralph M; Schad, Karin; Kamarashev, Jivko; Koch, Simon; French, Lars E; Hofbauer, Günther F L (2012). Trichophyton rubrum-induced Majocchi's Granuloma in a heart transplant recipient. A therapeutic challenge. Journal of Dermatological Case Reports, 6(3):70-72.

Abstract

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. Tricho-phyton 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.

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. Tricho-phyton 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.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Dermatology Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2012
Deposited On:08 Mar 2013 08:20
Last Modified:05 Apr 2016 16:39
Publisher:Specjaliści Dermatolodzy
ISSN:1898-7249
Publisher DOI:https://doi.org/10.3315/jdcr.2012.1105
PubMed ID:23091582
Permanent URL: https://doi.org/10.5167/uzh-76015

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