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Successful Treatment of Refractory Majocchi’s Granuloma with Voriconazole and Review of Published Literature

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Abstract

Majocchi’s granuloma (MG) is a rare deep skin dermatophyte infection that can occur either in immunocompetent or in immunocompromised individuals. Oral itraconazole or terbinafine is considered to be the first choice of treatment. We report an immunocompetent man with deep nodular form of MG, the form which is generally found in immunosuppressed individuals. Previous treatment with either oral itraconazole or terbinafine yielded no apparent improvement. After a series of examination, the man was diagnosed as having Trichophyton rubrum-induced MG mixed with bacterial infection as evidenced by growth of Klebsiella pneumoniae in tissue bacterial culture. The patient was treated with a combination of cefoselis and levofloxacin for bacterial clearance followed by voriconazole treatment. After approximately 4 months of voriconazole treatment, the lesions completely resolved. Alternative medicine (voriconazole) can be considered in case of refractory infections during MG treatment.

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Acknowledgments

This work was supported by the Jiangsu Province Postdoctoral Research Finding Schemes (1302032B).

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    Authors and Affiliations

    1. **ling Hospital, Department of Dermatology, Nan**g University, School of Medicine, Nan**g, 210002, People’s Republic of China

      H. B. Liu, F. Liu, Q. T. Kong & H. Sang

    2. Institute of Dermatology, Chinese Academy of Medical Sciences, Peking Union Medical College, Nan**g, 210042, People’s Republic of China

      Y. N. Shen, G. X. Lv & W. D. Liu

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    1. H. B. Liu
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    Correspondence to H. Sang.

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    H. B. Liu and F. Liu have contributed equally to this work.

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    Liu, H.B., Liu, F., Kong, Q.T. et al. Successful Treatment of Refractory Majocchi’s Granuloma with Voriconazole and Review of Published Literature. Mycopathologia 180, 237–243 (2015). https://doi.org/10.1007/s11046-015-9902-5

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