中国麻风皮肤病杂志 ›› 2025, Vol. 41 ›› Issue (3): 184-190.doi: 10.12144/zgmfskin202503184

• 论著 • 上一篇    下一篇

石膏样奈尼兹菌致心脏移植患者Majocchi's肉芽肿一例并文献分析

孙德祥1,路金明1,刘涛2,王梓赫1,刁晗1,王君1   

  1. 1 青岛大学附属医院皮肤科，山东青岛，266555； 2 青岛大学附属青岛中心医院，山东青岛，266042
  • 出版日期:2025-03-15 发布日期:2025-03-03

Majocchi's granuloma caused by Nannizzia gypsea in a transplant patient: a case report and literature review

SUN Dexiang1, LU Jinming1, LIU Tao2, WANG Zihe1， DIAO Han1， WANG Jun1   

  1. 1 Department of Dermatology, The Affiliated Hospital of Qingdao University, Qingdao 266555, China; 2 The Affiliated Qingdao Central Hospital of Qingdao University, Qingdao 266042, China
  • Online:2025-03-15 Published:2025-03-03

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摘要： 目的：报道我院诊断的石膏样奈尼兹菌致器官移植患者Majocchi's肉芽肿一例，并结合文献探讨甲癣与免疫状态对其发病的影响。方法：描述一例心脏移植患者右前臂石膏样奈尼兹菌引发的Majocchi's肉芽肿，并分析在PubMed数据库中检索的Majocchi's肉芽肿病例的特点，包括患者年龄、感染部位、致病真菌种类并治疗方法及疗效。数据分析采用单因素方差分析和卡方检验。结果：共分析41例患者，其中器官移植12例、长期免疫抑制10例和免疫正常19例。单因素方差分析结果表明，器官移植组和长期免疫抑制组患者的平均年龄显著高于免疫正常组（F=5.20，P＜0.05）。器官移植患者中甲真菌病发病率为58.3%，而长期免疫抑制组和免疫正常组分别为30%和21.1%，器官移植患者的甲真菌病发病率显著高于其他组，差异有统计学意义（χ2=8.34，P＜0.05）。器官移植组、免疫抑制组和免疫正常组中红色毛癣菌的感染率分别为83.3%、63.3%和25.6%，器官移植组和免疫抑制组中红色毛癣菌的感染率显著高于免疫正常组（χ2=16.63，P＜0.01）。结论：器官移植Majocchi's肉芽肿患者中，甲真菌病的发病率显著高于长期免疫抑制患者及免疫正常患者。

关键词: Majocchi's肉芽肿, 石膏样奈尼兹菌, 移植患者, 甲真菌病

Abstract: Objective: To report a case of Majocchi's granuloma caused by Nannizzia gypsea in a heart transplant recipient in our hospital, and the influence of onychomycosis and immune status on its pathogenesis was discussed combined with the literature. Methods: We describe a case of Majocchi's granuloma in the right forearm caused by Nannizzia gypsea in a heart transplant patient. The characteristics of Majocchi's granuloma cases retrieved from the PubMed database were analyzed, including patient age, infection site, types of pathogenic fungi, treatment methods and efficacy. Single factor analysis of variance and chi-square test were used for data analysis. Results: A total of 41 patients were analyzed, including 12 organ transplant patients, 10 patients with long-term immunosuppression and 19 immunocompetent patients. The results of single factor analysis of variance showed that the average age of patients in the organ transplant group and the long-term immunosuppression group was significantly higher than that in the immunocompetent group (F=5.20, P＜0.05). The incidence of onychomycosis in organ transplant group was 58.3%, while the incidences of onychomycosis in the long-term immunosuppression group and the immunocompetent group were 30% and 21.1% respectively. The incidence of onychomycosis in organ transplant patients was significantly higher than that in other groups, and the difference was statistically significant (χ2=8.34, P＜0.05). The infection rates of Trichophyton rubrum in organ transplant group, immunosuppression group and immunocompetent group were 83.3%, 63.3% and 25.6%, respectively. The infection rate of Trichophyton rubrum in organ transplant group and immunosuppression group was significantly higher than that in immunocompetent group (χ2=16.63, P＜0.01). Conclusion: Among organ transplant patients with Majocchi's granuloma, the incidence of onychomycosis is significantly higher than that in patients with long-term immunosuppression and immunocompetent patients.

Key words: Majocchi’s granuloma, Nannizzia gypsea, transplant patients, onychomycosis