title: Trichophyton rubrum Infection Characterized by Majocchi's Granuloma and Deeper Dermatophytosis: Case Report and Review of Published Literature.
abstract: Infections caused by Trichophyton rubrum are very common in dermatological disease. It most often appears as superficial cutaneous mycosis, such as tinea manuum, tinea pedis, and tinea corporis. However, deep infection caused by T. rubrum was rarely reported. We describe a case of mixed type of deep infection caused by T. rubrum in a 45-year-old man with no significant immunodeficiency. This patient had a history of onychomycosis on the toenails without regular treatment for nearly 6 years. And, he had erythema, papule, and nodules on the submandibular area, neck, and chest for almost 1 year. After treated with intravenous infusion of cefotiam for 2 weeks, the lesion aggravated. The fungal direct microscopic examination of pyogenic fluid was positive, and the fungal cultures that produced reddish-brown and yellow pigment showed cottony, wooly, and white colony. After the DNA sequencing, it was identified as T. rubrum. We gave the patient oral terbinafine 250 mg per day and bifonazole cream for external use. Six months later, the patient's skin lesion was disappeared, and healthy nail growth was seen in two-thirds of nail bed. The terbinafine is effective against deep infection caused by T. rubrum.
authors.affiliation: Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China.
authors.forename: Huilin
authors.initials: H
authors.lastname: Su
authors.affiliation: Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China.
authors.forename: Benlin
authors.initials: B
authors.lastname: Cheng
authors.affiliation: Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China.
authors.forename: Junhao
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China.
authors.forename: Qiangqiang
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China. xjhhsyy@126.com.
authors.forename: Jinhua
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China. Juneminmyco@126.com.
authors.forename: Min
authors.initials: M
authors.lastname: Zhu
mesh_terms: D003881:Dermatomycoses / Q000175:diagnosis* / Q000473:pathology*; D006099:Granuloma / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D008297:Male; D008828:Microbiological Techniques; D008853:Microscopy; D008875:Middle Aged; D017422:Sequence Analysis, DNA; D014005:Tinea / Q000175:diagnosis* / Q000473:pathology*; D014249:Trichophyton / Q000302:isolation & purification*
keywords: Deep infection; Onychomycosis; Terbinafine; Trichophyton rubrum