, Volume 176, Issue 5–6, pp 457–462 | Cite as

Extensive Deep Dermatophytosis Cause by Trichophyton rubrum in a Patient with Liver Cirrhosis and Chronic Renal Failure

  • Lung-Chi Wu
  • Pei-Lun Sun
  • Yun-Ting ChangEmail author


Dermatophytes are the main pathogen of superficial skin fungal infections. On rare occasions, they can cause deep and extensive infections, especially in immunocompromised hosts. We reported a 48-year-old patient with liver cirrhosis and chronic renal failure who developed an extensive deep dermatophytosis with possible hematogenous dissemination. Skin histopathology showed extensive involvement of hair follicles and dermis by fungal elements. The pathogen was cultured from both skin biopsy specimen and central venous line. It was identified as Trichophyton rubrum by morphology and further conformed by sequencing of internal transcribed spacers of ribosomal DNA. The patient died quickly before the identification was available.


Extensive Deep Dermatophytosis Trichophyton rubrum Liver cirrhosis Chronic renal failure 


  1. 1.
    Blank F, Mann SJ. Trichophyton rubrum infections according to age, anatomical distribution and sex. Br J Dermatol. 1975;92:171–4.PubMedCrossRefGoogle Scholar
  2. 2.
    Chastain MA, Reed RJ, Pankey GA. Deep dermatophytosis: report of 2 cases and review of the literature. Cutis. 2001;67:457–62.PubMedGoogle Scholar
  3. 3.
    Voisard JJ, Weill FX, Beylot-Barry M, Vergier B, Dromer C, Beylot C. Dermatophytic granuloma caused by Microsporum canis in a heart-lung recipient. Dermatology. 1999;198:317–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Grossman ME, Pappert AS, Garzon MC, Silvers DN. Invasive Trichophyton rubrum infection in the immunocompromised host: report of three cases. J Am Acad Dermatol. 1995;33:315–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Novick NL, Tapia L, Bottone EJ. Invasive Trichophyton rubrum infection in an immunocompromised host. Case report and review of the literature. Am J Med. 1987;82:321–5.PubMedCrossRefGoogle Scholar
  6. 6.
    Squeo RF, Beer R, Silvers D, Weitzman I, Grossman M. Invasive Trichophyton rubrum resembling blastomycosis infection in the immunocompromised host. J Am Acad Dermatol. 1998;39:379–80.PubMedCrossRefGoogle Scholar
  7. 7.
    Wu P-Y, Cheng Y-L, Horng S-F, Shen J-L. Majocchi’s granuloma caused by Trichophyton rubrum in a renal transplant recipient. Dermatol Sinica. 2002;20:253–257.Google Scholar
  8. 8.
    Gong JQ, Liu XQ, Xu HB, Zeng XS, Chen W, Li XF. Deep dermatophytosis caused by Trichophyton rubrum: report of two cases. Mycoses. 2007;50:102–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Janniger CK. Majocchi’s granuloma. Cutis. 1992;50:267–8.PubMedGoogle Scholar
  10. 10.
    Smith KJ, Neafie RC, Skelton HG III, Barrett TL, Graham JH, Lupton GP. Majocchi’s granuloma. J Cutan Pathol. 1991;18:28–35.PubMedCrossRefGoogle Scholar
  11. 11.
    Araviysky AN, Araviysky RA, Eschkov GA. Deep generalized trichophytosis. (Endothrix in tissues of different origin). Mycopathologia. 1975;56:47–65.PubMedCrossRefGoogle Scholar
  12. 12.
    Lestringant GG, Lindley SK, Hillsdon-Smith J, Bouix G. Deep dermatophytosis to Trichophyton rubrum and T. verrucosum in an immunosuppressed patient. Int J Dermatol. 1988;27:707–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Sentamilselvi G, Janaki C, Kamalam A, Thambiah AS. Deep dermatophytosis caused by Trichophyton rubrum–a case report. Mycopathologia. 1998;142:9–11.PubMedCrossRefGoogle Scholar
  14. 14.
    Marconi VC, Kradin R, Marty FM, Hospenthal DR, Kotton CN. Disseminated dermatophytosis in a patient with hereditary hemochromatosis and hepatic cirrhosis: case report and review of the literature. Med Mycol. 2010;48:518–27.PubMedCrossRefGoogle Scholar
  15. 15.
    Porubcin S, Porubcinova I, Kristian P, Virag L, Stammova E, Vyhnankova V, Paralicova Z. Invasive pulmonary aspergillosis and esophageal candidiasis in a patient with decompensated liver cirrhosis due to chronic hepatitis C and alcohol. Klin Mikrobiol Infekc Lek. 2012;18:17–21.PubMedGoogle Scholar
  16. 16.
    Alidjinou K, Mathieu D, Colombel JF, Francois N, Poulain D, Sendid B. Triple fungal infection in a patient with liver cirrhosis. Ann Biol Clin (Paris). 2012;70:89–92.Google Scholar
  17. 17.
    Miranda EJ, Goncalves LG, Franca FO. Cryptococcal meningitis in HIV-negative patient with liver cirrhosis due to hepatitis C. Braz J Infect Dis. 2011;15:399–400.PubMedGoogle Scholar
  18. 18.
    Falcone M, Massetti AP, Russo A, Vullo V, Venditti M. Invasive aspergillosis in patients with liver disease. Med Mycol. 2011;49:406–13.PubMedCrossRefGoogle Scholar
  19. 19.
    Singh DK, Tyagi I, Saran RK, Gondal R. Fatal spontaneous Cryptococcal peritonitis in a woman with decompensated liver cirrhosis. Acta Cytol. 2010;54:1087–9.PubMedGoogle Scholar
  20. 20.
    Pellicelli AM, D’Ambrosio C, Villani R, Cerasari G, Ialongo P, Cortese A, Grillo LR, Soccorsi F. Liver cirrhosis and rhino-orbital mucormycosis, a possible but rare association: description of a clinical case and literature review. Braz J Infect Dis. 2009;13:314–6.PubMedCrossRefGoogle Scholar
  21. 21.
    Sikorski T, Marcinowska-Suchowierska E. Cryptococcal ascites and ascitic lymphocytosis in cirrhotic patients. Am J Med. 2007;120:e23; author reply e5.Google Scholar
  22. 22.
    Miura T, Kawakami Y, Otsuka M, Hachiya M, Yamanoi T, Ohashi K, Suzutani T, Yamamoto T. Cutaneous cryptococcosis in a patient with cirrhosis and hepatitis C virus infection. Acta Derm Venereol. 2010;90:106–7.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  1. 1.Department of DermatologyTaipei Veterans General HospitalTaipeiTaiwan
  2. 2.Department of Internal MedicineTaichung Armed Forces General HospitalTaichungTaiwan
  3. 3.National Defense Medical CenterTaipeiTaiwan
  4. 4.Department of DermatologyMackay Memorial HospitalTaipeiTaiwan
  5. 5.Institute of Ecology and Evolutionary BiologyNational Taiwan UniversityTaipeiTaiwan
  6. 6.Department of DermatologyNational Yang-Ming UniversityTaipei 112Taiwan

Personalised recommendations