A case of Majocchi's granuloma combined with Mycobacterium massiliense infection a renal transplant re-cipient
DENG Yuxuan
HU Jian
JIN Jiang
LI Houmin
Abstract：A 58-year-old male presented with rash and swelling on the left ankle for 3 years,aggravated for 1 months.The patient had undergone renal transplantation eighteen years earlier and had been immunosuppressed with tacrolimus,myco-phenolate mofetil,and methylprednisolone.Physical examination revealed that multiple dark red nodules on the dorsal side of the left ankle,and some of them were fused into plaques.A linear incision was visible in the center of most nodules,ac-companied by a slight exudation of pus.Both heels and lateral edges of the feet showed obvious excessive keratinization,dry-ness,and peeling.Histopathological examination found that diffuse proliferation of fibrous tissue and small blood vessels throughout the dermis,accompanied by infiltration of numerous lymphocytes,neutrophils,plasma cells,and tissue cells.Methenamine silver and PAS staining showed a few fungal hyphae and spores in the deep dermis.Metagenomics next genera-tion sequencing of the lesion tissue showed Trichophyton rubrum.During the treatment period,the blood culture was posi-tive,and the bacterial strain was identified as Mycobacterium massiliense.The chest CT and lumbar MRI showed new infec-tion.The patient was finally diagnosed as Majocchi's granuloma caused by T.rubrum combined with disseminated M.mas-siliense infection.The skin lesions basically subsided after six months treatment with oral terbinafine against fungi,azithro-mycin,ethambutol,moxifloxacin,clofazimine,and contezolid against non-tuberculosis mycobacteria.
Keywords：Trichophyton rubrumMycobacterium massilienseMajocchi's granulomakidney transplantation
Publication Date：2025-04-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 184-187 )