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

Area of Science:

• Dermatology
• Infectious Diseases
• Pharmacology

Background:

• Solid organ transplant recipients require immunosuppression, increasing susceptibility to infections.
• Dermatophyte fungal infections are common in transplant patients, potentially leading to Majocchi's granuloma.
• Itraconazole is a key antifungal agent for cutaneous and mucosal infections.

Observation:

• A heart transplant recipient developed extensive Trichophyton rubrum infection.
• The infection presented as Majocchi's granuloma.
• Treatment with itraconazole was complicated by drug interactions and variable dosing.

Findings:

• Despite varied itraconazole treatment, Trichophyton rubrum infection persisted.
• The patient experienced widespread disease progression.
• Drug interactions and altered absorption may impact itraconazole efficacy.

Implications:

• Consider drug interactions and absorption issues in refractory Trichophyton rubrum infections in transplant patients.
• Close monitoring and dose adjustment of itraconazole are crucial for treatment success.
• This case underscores the importance of vigilant management in immunocompromised individuals with fungal infections.