我国首次发现的暗纹节菱孢所致皮肤真菌病的毒理实验及病理分析

从患者皮损处皮屑及活检组织中分离出的暗纹节菱孢Arthriniumphaeospermum（Corda）Ellis菌株制成混悬菌液,用兔、豚鼠及小鼠（LACA）进行动物毒理实验。表皮直接涂抹法接种,四周后未见皮肤损害;划破表皮涂沫法及皮下注射法接种,两周后实验动物的皮肤都出现浸润性斑块、小给节、皮下脓肿及脱毛的症状,对照组动物正常。再用腹腔注射法接种,小鼠两周后死亡,病解所见,腹膜、肠系膜、腹壁及肝等处,均出现散在的灰白色小脓肿;心、肺、肝、脾及肾均有病变。豚鼠两周后仍存活,当即处死解剖所见与小鼠病解改变相同。对实验动物皮损、腹膜、肠系膜、胃及肝等处的小脓肿组织进行了病理检查,结果发现皮损及器官组织均有明显的病理浸润,由多种细胞构成的浸润性肉芽肿。在病理浸润内可见大小不等的球形、卵圆形、棱形及晶体形的棕色、红色孢子．其病理改变与患者皮损病理改变相一致,其不同点是实验动物有小脓肿,肉芽肿内可见多核巨噬细胞,而在病人皮损中很少见到。     

暗孢节菱孢菌引起面部感染1例及相关研究

目的报道暗孢节菱孢菌(Arthrinium phaeospermum)引起的面部皮肤感染1例并进行相关真菌学研究。方法患者女,29岁,两颊对称性浸润性红斑数年。皮损直接镜检、真菌培养,经形态观察、分生鉴定菌种、并进行体外药敏试验及利用豚鼠致病性实验重现组织病理特征。结果直接镜检未见明显菌丝,体外培养后为单一菌落,经棉兰染色、小培养、扫描电镜、分子生物学均鉴定为暗孢节菱孢菌(Arthrinium phaeospermum),均可见典型特征。体外药敏试验提示,该菌对卡泊芬净、米卡芬净、泊沙康唑、雷夫康唑、伏立康唑、特比萘芬敏感,对伊曲康唑、氟康唑耐药。豚鼠致病性实验中,对照组和免疫抑制组豚鼠皮下注射处大体可见脓肿,体表涂抹处大体表现红斑、丘疹、脱屑,免疫抑制组症状持续较久。皮下注射处较体表涂抹处有明显的组织病理学改变,可见多核巨细胞包裹菌丝或孢子,伴组织细胞、中性粒细胞、淋巴细胞浸润。结论该患者为罕见的暗孢节菱孢菌(Arthrinium phaeospermum)引起的皮肤真菌感染。免疫功能对该菌感染所致疾病的临床过程可能有影响。     

枝状枝孢引起皮肤暗色丝孢霉病1例

目的报道1例枝状枝孢引起的皮肤暗色丝孢霉病。方法采用10％KOH镜检、真菌培养、小培养、温度试验、明胶液化试验、体外药敏试验、组织病理检查。结果皮损脓液10％KOH镜检见有棕黄色分隔菌丝;沙堡弱培养基（SDA）培养出局限性、绒状、橄榄绿色菌落;马铃薯葡萄糖琼脂培养基（PDA）小培养,孢梗多侧生于菌丝上,不分枝,产孢后不延伸、不膨大,淡褐色,具孢痕,枝孢呈长三角形,分生孢子顶生或侧生于其上,形成分枝的孢子链;最适应生长温度为25—27℃;能液化明胶。因此,本菌株符合枝状枝孢特征。而皮损组织病理显示真皮内弥漫性炎性细胞浸润以及肉芽肿病理相,伴有真菌菌丝孢子侵犯,诊断为皮肤暗色丝孢霉病。体外药敏试验结果显示本菌株对伊曲康唑敏感,给予患者口服0．4g／d,8周后皮损基本消退,目前仍在服药及随访。结论本病例的致病菌为枝状枝孢,选用伊曲康唑治疗有效。     

我国首次发现的暗纹节菱孢所致皮肤真菌病的毒理实验及病理分析

从患者皮损处皮屑及活检组织中分离出的暗纹节菱孢Ａｒｔｈｒｉｎｉｕｍｐｈａｅｏｓｐｅｍｕｍ（Ｃｏｒｄａ）Ｅｌｌｉｓ菌株制成混悬菌液,用兔,豚鼠及小鼠（ＬＡＣＡ）进行动物毒理实验,表皮直接涂抹法接种,四周后未见皮肤损害,划破表皮涂沫法及皮下注射法接种,两周后实验动物的皮肤都出现浸润性斑块,小结节,皮下脓肿及脱毛的症状,对照组动物正常,再用腹腔注射法接种,小鼠两周后死亡,病解所见,腹膜,肠系膜,腹壁及肝     

茄病镰刀菌致皮肤透明丝孢霉病1例

目的报告1例茄病镰刀霉引起的皮肤透明丝孢霉病。方法从患者皮损取材作真菌镜检、培养及组织病理学检查。结果直接镜检及组织病理切片均发现真菌菌丝,3次培养均为同一菌株生长。镜下可见大分生孢子基部细胞短、钝圆,小分生孢子呈假头状着生,可见厚壁孢子。根据以上形态学特征鉴定为茄病镰刀菌。结论对于透明丝孢霉病应早期诊断,并进行体外抗真菌药物的敏感试验,明确并有效控制基础疾病。     

Microsphaeropsis arundinis引起右前臂皮肤暗色丝孢霉病1例及文献分析CSCD

患者,男,80岁,农民,右前臂外侧浸润性红斑、结节、结痂1年余,糖尿病史10年。右前臂外侧可见浸润性红斑、斑块上间有小结节和疣状增生,上覆有黑色结痂,皮损面积5 cm×10 cm。刮取皮屑直接镜检发现菌丝,活检组织标本真菌直接镜检也发现菌丝。真菌培养均长出灰褐色绒毛状菌落,周围有灰白色边缘。玻片小培养可见分隔菌丝,个别节段膨大,分生孢子呈椭球形。表皮假上皮瘤样增生、真皮内可见淋巴细胞、中性粒细胞、组织细胞以及多核巨细胞浸润的肉芽肿性炎症。过碘酸-雪夫(PAS)染色显示,真皮内有多个紫红色圆形芽殖孢子。分离菌株的分子测序结果与Microsphaeropsis arundinis的ITS片段序列100%符合。口服伊曲康唑胶囊400 mg/d,5个月后皮损得到明显改善,目前仍在治疗和观察中。回顾2000年—2021年M.arundinis引起相关感染的国内外文献,探讨M.arundinis导致暗色丝孢霉病的临床特征。     

变质甘蔗中毒病原菌节菱孢的分类鉴定

对163株从中毒甘蔗和变质甘蔗样品中分离的产毒节菱孢进行了分类鉴定,其中98株定名为甘蔗节菱孢(Arthrinium sacchari M.B.Ellis),占60.1％;43株定名为蔗生节菱孢(A.saccharicola Stevenson),占26.4％;22株为暗孢节菱孢[A.phaeospermum(Corda)M.B.Ellis],占13.5％。前两个种为国内新记录。并用小培养法及扫描电镜观察了分生孢子的形态及着生特点。     

桔青霉引起透明丝孢霉病1例及文献总结CSCD

报告1例由桔青霉(Penicillium citrinum)引起的透明丝孢霉病并对相关文献进行回顾分析。患者,女,55岁,因左前臂斑块、结节4个月余就诊。对患者皮损表面的皮屑进行真菌荧光镜检,镜下可见少许菌丝;手术取活检组织,同时病理检查、细菌培养及真菌培养,真菌培养阳性,组织病理结果提示感染性肉芽肿,经PAS染色可见组织内菌丝及孢子;提取源自活检组织的真菌DNA和源自蜡块组织的DNA,对ITS区扩增并通过测序比对鉴定为桔青霉,与形态学鉴定相符。微量液基稀释法测得伊曲康唑对此桔青霉的最低抑菌浓度为0.5μg/mL。诊断为桔青霉所致透明丝孢霉病,予伊曲康唑200 mg/d口服治疗1个月后明显改善。     

小双孢菌属的两个新种

从我国四川和香港土壤中分离出四株小双孢菌,编号分别为18、71、72和32号。前三株菌气生菌丝短,较贫乏,产生成纵对孢子,有时产生深褐色素,鉴定为棕褐小双孢菌新种(Microbispors brunnea sp.nov．)。32号菌株气丝青灰色,产生成纵对的梭形孢子,孢子表面有明显的鞘膜,鉴定为青灰小双孢菌新种(Microbispora caesia sp.nov)。     

采用EF-1α序列及气生菌丝上的孢子形态特征对九州镰孢菌、拟枝孢镰孢菌和厚垣镰孢菌的鉴定

对九州镰孢菌Fusarium kyushuense、厚垣镰孢菌F. chlamydosporum 和拟枝孢镰孢菌F. sporotrichioides在气生菌丝上产生的孢子进行了比较。九州镰孢菌在气生菌丝上产生多隔孢子（即中型分生孢子）;厚垣镰孢菌在气生菌丝上产生的主要是0隔针叶状分生孢子;拟枝孢镰孢菌在气生菌丝上产生两种类型的分生孢子：芜菁形、单胞分生孢子以及椭圆形、0－1隔的分生孢子。多隔的气生孢子（中型分生孢子）在厚垣镰孢菌和拟枝孢镰孢菌这两个种中偶尔可以观察到,但是不应作为对这两个种进行鉴定的主要     

Hombre de 18 años con síndrome verrugoso tropical: ¿leishmaniasis o esporotricosis?

The tropical verrucous syndrome includes infectious, chronic, and granulomatous skin conditions appearing with plaques, nodules, or ulcers with a warty surface which gives name to the syndrome. It includes forms of chromoblastomycosis, sporotrichosis, paracoccidioidomycosis, lobomycosis, leishmaniasis, and tuberculosis verrucosa cutis with ample distribution in tropical and subtropical areas. The diagnoses may be difficult and confused among them, especially between sporotrichosis and leishmaniasis.Clinical, epidemiologic, intradermal reactions, direct smears, skin biopsies, cultures, immunofluorescence, and PCR are used to differentiate them, although several of these methods are not commonly used.We present an 18-year-old man with extensive verrucous plaques in one knee interpreted by clinic, epidemiology, and biopsy as verrucous cutaneous leishmaniasis. He was treated with Glucantime® for 20 days without improvement. A new biopsy was made that was also interpreted as cutaneous leishmaniasis. The revision of both biopsies showed inflammation with abscessed granulomas and asteroid sporotrichotic bodies at the center of the granulomas that led to the diagnosis of sporotrichosis later confirmed by the fungus culture. The patient responded to the treatment with itraconazole. As clinical and epidemiological findings of leishmaniasis and sporotrichosis can be similar, skin biopsy and other paraclinical studies are necessary to establish a proper diagnosis. The asteroid sporotrichotic body is pathognomonic of this mycosis. We review here the essential concepts of leishmaniasis and sporotrichosis and the criteria to differentiate them.     

<Emphasis Type="Italic">Paracoccidioides brasiliensis</Emphasis> Infection Mimicking Recurrent Hodgkin Lymphoma: A Case Report and Review of the Literature

Paracoccidioides infection is a rare entity in the USA. This dimorphic fungus is found in Central and South America and is thought to be acquired by inhalation through the soil. We report a case of Paracoccidioides brasiliensis infection presenting as a clavicular bone lesion, peripancreatic mass, and various skin lesions. A 35-year-old man with a history significant for Hodgkin lymphoma presented with a left clavicular mass that was suspected clinically and radiologically as recurrent Hodgkin lymphoma. He was not experiencing any associated symptoms and was undergoing chemotherapy treatment for his known Hodgkin disease. On CT imaging, the mass was seen as a lytic bone lesion with an overlying soft tissue mass. This was biopsied and histologically diagnosed as a Paracoccidioides brasiliensis infection with associated necrotizing granulomatous inflammation. Also found on the CT scan was an enlarging peripancreatic mass which on endoscopic biopsy had similar histologic findings. In conclusion, this report presents a rare case of Paracoccidioides brasiliensis infection mimicking recurrent Hodgkin lymphoma.     

Psychogenic alopecia in rhesus macaques presenting as focally extensive alopecia of the distal limb

Focally extensive alopecia affecting the distal limbs is a common clinical finding in rhesus macaque (Macaca mulatta) colonies and is both a regulatory and colony-health concern. We performed diagnostic examinations including physical exams, bloodwork, skin scrapes, surface cytology, and surface bacterial-fungal cultures on 17 rhesus macaques with this presentation of alopecia. Skin biopsies from alopecic skin obtained from each macaque were compared with those of normal skin from the same animal. Immunohistochemistry and metachromatic staining for inflammatory cells were performed to compare alopecic and normal skin. In addition, we compared these biopsies with those previously obtained from macaques with generalized alopecia and dermal inflammatory infiltrates consistent with cutaneous hypersensitivity disorders and with those from animals with normal haircoats. Bacterial and fungal cultures, skin scrapes, surface cytology, and bloodwork were unremarkable. Affected skin showed only mild histologic alteration, with rare evidence of trichomalacia and follicular loss. Numbers of mast cells and CD3+ lymphocytes did not differ between alopecic and normally haired skin from the same animal. The number of mast cells in alopecic skin from animals in the current cohort was significantly lower than that in skin of animals previously diagnosed with a cutaneous hypersensitivity disorder. Numbers of both mast cells and CD3+ lymphocytes in alopecic skin from the current cohort were similar to those from biopsies of animals with normal haircoats. Together, the clinical findings and pathology are consistent with a psychogenic origin for this pattern of alopecia in rhesus macaques.     

Demodectic mange in a tamarin (Saguinus geoffroyi)

A young female tamarin (Saguinus geoffroyi) developed erythema, alopecia, and papule formation on the skin of the limbs, tail, and head. Examination of skin scrapings and a biopsy specimen revealed mites identified as Demodex sp. Histologically the mites were found in hair follicles, and they were associated with focal degenerative and inflammatory changes in the skin. Successful treatment included topical application of 1% ronnel solution and rotenone ointment.     

Micosis cutánea por Curvularia pallescens en un paciente trasplantado pulmonar: primer caso descrito en España

BackgroundCurvularia is a filamentous dematiaceous fungus increasingly recognized as a pathogen in immunocompromised patients. The most common clinical entities associated with this fungus are allergic sinusitis, cutaneous infection and keratitis. In this article, a report on the first clinical case of Curvularia pallescens cutaneous infection in Spain and its treatment is described.Case reportA 68 year-old man with a history of lung transplantation presented to Dermatology Unit due to a skin lesion in the knee that had been evolving for 6 months. A skin biopsy was performed for its study. In the histopathological study, an intense and non-specific inflammatory reaction in the dermis was observed, and with Grocott stain and periodic acid Schiff abundant septate hyphae and spores were found in the dermis. The culture of the sample revealed a filamentous fungus whose microscopic examination allowed to identify the genus as Curvularia. Using MALDI-TOF mass spectrometry and molecular identification, the fungus was finally identified as Curvularia pallescens. The patient underwent surgical resection of the lesion and was treated with posaconazole, evolving favorably.ConclusionsThe species of Curvularia should be considered causal agents of fungal skin infections in immunosuppressed patients. This clinical case, which showed good clinical response after surgical resection and treatment with posaconazole, is the first described in Spain due to this species.     

Occurrence of melanin granules and melanosynthesis in the kidney of Sparus auratus

An optical, ultrastructural, and biochemical study of the melanin accumulation nodules found in the kidney of the teleost fish Sparus auratus is presented. These nodules are randomly distributed in the interstitium of the renal tissue. They are formed by large aggregates of cells replete with melanin granules. The melanin granules occur singly or also in aggregates inside the cells. Most of the granules are electron-dense, but sometimes small electron-lucent spaces within them can be seen. Some secondary lysosomes and dendritic processes can also be observed. Biochemical studies have proved for the first time the existence of measurable tyrosinase activity in those nodules. That activity was assayed using three methods: tyrosine hydroxylation, dopa oxidation, and melanin formation. Furthermore, inhibitors of well-characterized plant and animal skin tyrosinases were effective agents for inhibiting those activities in fish kidney preparations. This finding supports the notion of the existence of true tyrosinase in the melanin accumulation nodules of this tissue. Taking into account the results obtained, the origin and functions of the melanin-containing cells found in the teleost fish kidney are discussed.     

茄病镰刀菌致ICR小鼠局部皮肤感染的实验研究

目的建立茄病镰刀菌感染皮肤的ICR小鼠模型。方法将茄病镰刀菌三个不同浓度的菌悬液分别接种于正常和免疫抑制ICR小鼠受损及正常未受损的皮肤,于接种后第7、14、21、28天处死动物,取皮疹和各脏器进行真菌镜检、培养和组织病理学检查。结果正常和免疫抑制组皮肤受损的小鼠均出现皮疹,而免疫抑制组皮疹程度重,持续时间长,且真菌镜检、培养及组织病理学大都可见菌丝。皮肤未受损的小鼠不发生皮疹。实验小鼠均未出现系统播散。结论接种109CFU/mL或1010CFU/mL茄病镰刀菌的孢子悬液于免疫抑制ICR小鼠擦伤的皮肤,可有效造成ICR小鼠的茄病镰刀菌皮肤感染。     

Studie über einen Trichophyton - quinckeanum -Stamm mit ausgeprägter Fluoreszenz des Scutulums em Tierversuch

A vesicular skin lesion which existed since 1 week in the lower part of the leg of a 45-year-old woman appeared to be caused by fungus which was identified as Trichophyton quinckeanum (Zopf) MacLeod & Muende. The patient could not state to have had contact with animals. Peroral administration of griseofulvin and local application of 2% salicyl--5% sulfur--vaseline alternate with tonoftal cream healed the lesion completely. The fast growing fungus produced white, convoluted colonies with a brown, lat er wine-red reverse. Globose and club-shaped, one- and two-celled microconidia were formed especially 'en thrse'. The majority of the thin-walled macroconidia had rounded apices but a fusiform type of spore was also seen. Germination of the macroconidia was frequently observed. Experimental infection into the dorsal skin of white laboratory mouse produced a scutulum with a bright yellow later green fluorescence in Wood's light. The taxonomy of Trichophyton quinckeanum is briefly discussed.     

Herpes-like viral dermatitis in a beluga whale (Delphinapterus leucas)

Approximately 3.5 mo following its capture, a beluga whale (Delphinapterus leucas) developed focal pale gray skin lesions. These lesions persisted for at least 8 mo. A biopsy from one of these sites revealed epithelial intranuclear inclusions. Herpes-like viral particles were seen by transmission electron microscopy. The eventual regression of skin lesions and lack of other clinical signs suggests the virus was only mildly pathogenic in this animal.