密切接触宠物兔后幼儿鼻孔周围体癣1例

报道1例密切接触宠物兔后发生在幼儿双侧鼻孔周围及上唇部的体癣。患儿4岁,因“鼻唇部红斑、鳞屑、伴瘙痒10余日”就诊。取皮屑镜检见真菌菌丝及毳毛内孢子,培养见棒形分隔大分生孢子、葡萄串状小分生孢子及螺旋菌丝。尿素酶试验阳性、毛发穿孔试验阳性,鉴定为须癣毛癣菌。经内服伊曲康唑胶囊和外用萘替芬酮康唑乳膏治疗6d后红斑瘙痒明显减轻,34d后皮损消退。复查真菌阴性。     

须癣合并面颈部体癣1例

患者男,57岁。面部红斑、丘疹、唇部脓疱灼痛2个月余。曾口服和外用多种中药治疗无效且呈加重趋势。取皮屑、胡须镜检见大量真菌菌丝,培养见棒状分隔大分生孢子、葡萄串状小分生孢子。尿素酶实验阳性、毛发穿孔实验阳性,鉴定为须癣毛癣菌。经内服伊曲康唑胶囊和外用盐酸布替萘芬乳膏治疗10 d后病情好转,2个月后皮损消退。复查真菌阴性。     

须癣毛癣菌所致面部体癣继发癣菌疹1例

报道1例由须癣毛癣菌引起面部体癣后继发的癣菌疹。患者女,10岁,因右眶周红斑、鳞屑10 d就诊。鳞屑直接镜检查见菌丝,培养生长的菌落鉴定为须癣毛癣菌。内服特比萘芬、外用萘替芬酮康唑乳膏治疗8 d后面部及颈胸部出现片状红斑,考虑为癣菌疹,加服抗过敏、抗炎药物(左西替利嗪、复方甘草酸苷片)、外用卤米松/三氯生软膏14 d后皮损消退。     

疑似红斑狼疮的面部难辨认癣1例

报告1例面部难辨认癣 患者为21岁女性,农民,由于长期外用糖皮质激素软膏而使局部皮损不典型,当地医师怀疑为红斑狼疮建议到我院做全面检查。病损标本真菌镜检发现菌丝,培养分离出须癣毛癣菌。免疫学检查排除红斑狼疮。病理检查在角质层及毛囊周围发现真菌菌丝。内服特比萘芬3周治愈。     

须癣毛癣菌致儿童脓癣1例

报道由须癣毛癣菌引起的儿童头部脓癣1例.患儿为4岁幼女,因头皮部丘疹1个月,脓肿4d就诊.内服青霉素V钾无效.取断发镜检查见发外真菌孢子,培养鉴定为须癣毛癣菌,细菌培养为棒状杆菌.经内服和外用特比萘芬抗真菌,静脉输入头孢噻肟钠联合克林霉素及万古霉素抗细菌治疗,12d后脓肿减轻,细菌培养阴转,但真菌培养仍阳性,继续抗真菌治疗2个月后皮损消退,真菌检查阴性.     

面癣误诊1例

报道由须癣毛癣菌感染引起并被长期误诊的面癣1例。患者女,37岁,因"面部反复红斑、丘疹、水疱伴瘙痒半年"就诊。多次被误诊为单纯疱疹、脓疱疮、湿疹、皮肤感染、脂溢性皮炎及玫瑰痤疮等,先后应用抗病毒、抗感染和抗过敏治疗,皮损未能完全消退并逐渐扩大。再次就诊,真菌学直接镜检阳性,真菌培养为须癣毛癣菌。给予口服特比萘芬片、外用联苯苄唑乳膏治疗后痊愈。     

误诊为头皮脓肿经抗生素及植皮治疗无效的脓癣——附2例报告

目的 报道2例误诊为头皮脓肿经长期抗生素及植皮治疗失败的须癣毛癣菌所致的脓癣病患者,分析脓肿和脓癣的鉴别要点。方法 例1为9岁男童,头皮外伤后脓肿、溃疡28d,经抗生素治疗无效,行植皮术后5d再发生脓肿溃疡。取皮损处断发行10％KOH涂片镜检、培养,发现并分离出致病真菌,沙堡弱琼脂培养基上呈白色粉状菌落,可使含尿素培养基变红,即尿素酶试验阳性,小培养见螺旋菌丝及分隔棒状大分生孢子,鉴定为须癣毛癣菌。例2为8岁女童,头顶脓肿、溃疡24d,抗感染治疗不愈而接受植皮,术后7d再发脓性丘疹。从皮损处标本中发现、分离出致病真菌,经上述方法鉴定为须癣毛癣菌。结果 2例患者结合真菌学检查和临床表现确诊为脓癣,予伊曲康唑100mg／d内服近2个月皮损均痊愈,但供皮区遗留瘢痕和色素改变。结论 真菌病原学检查是避免脓癣误诊的关键,伊曲康唑内服治疗脓癣有效、安全。     

15例人畜共患体癣的临床分析

目的通过对生活在同一家庭患有体癣的患者、家庭成员和所养宠物进行观察和分析,探讨人畜共患癣病的常见致病菌种以及治疗方案。方法收集2005年3月～2009年1月就诊于我院因接触宠物而致病的体癣患者,对其宠物的带菌情况进行调查,确诊后给予外用特比萘芬乳膏或联苯苄唑凝胶,未愈者给予口服伊曲康唑治疗。结果共收集15例患者,真菌培养结果显示8例为石膏样小孢子菌,4例为须癣毛癣菌,3例为犬小孢子菌。患者皮损真菌培养结果和所养宠物皮损真菌培养结果一致。按上述方法对患者及其宠物进行治疗,所有患者和10只(3只被丢弃)宠物全部治愈。结论 15例人畜共患体癣中,石膏样小孢子菌感染所致的比例最高,其次是须癣毛癣菌和犬小孢子菌,外用特比萘芬乳膏或联苯苄唑凝胶以及口服伊曲康唑胶囊可以有效治疗此类人畜共患皮肤癣菌病。     

迁延性黑点癣1例

目的报道病程30余年、由紫色毛癣菌感染所致成人黑点癣1例。方法对头发及鳞屑标本进行多次真菌直接镜检和培养,对病原菌进行形态学鉴定和药物敏感性试验。结果鉴定为紫色毛癣菌。体外药敏试验该菌对特比萘芬、伊曲康唑敏感。结论本病例证实为紫色毛癣菌感染导致黑点癣,患者经口服伊曲康唑和局部治疗痊愈。     

须癣毛癣菌在特比萘芬作用前后的电镜下形态学变化

主要综述了须癣毛癣菌在特比萘芬作用前、后的形态学变化。当特比萘芬作用于须癣毛癣菌后,因浓度不同而发生程度不同的超微结构改变。在扫描电子显微镜下菌丝发生弯曲和肿胀,顶端和中间出现球状膨大,菌丝变短粗,甚至坍陷、剥脱、破裂。分生孢子的细胞壁表面粗糙、出现小孔、凹陷、甚至外层剥脱。在透射扫描电子显微镜下,皱缩的胞浆膜和细胞外壁之间或细胞核内出现电子致密颗粒,胞浆膜、核膜、线粒体膜等不连续甚至出现变性。分生孢子细胞壁外层剥离,细胞膜被破坏,胞浆内出现膨大的空泡和电子致密区,并黏附到胞浆膜上。     

须癣毛癣菌致人兔共患体癣3例

报道须癣毛癣菌引起的人兔共患体癣3例.患者皮损均为环状红斑丘疹,上覆鳞屑,炎症明显,伴瘙痒,均与兔子有密切接触史,且兔子均有明显皮损.取患者及兔子的皮屑真菌镜检及培养,鉴定为须癣毛癣菌,经口服及外用抗真菌药物后治愈.     

须癣毛癣菌的形态学及分子生物学鉴定

目的对临床上分离自人(36株)及狐狸(5株)的须癣毛癣菌菌株进行新的分类系统鉴定,并检测传统的分类方法是否能满足临床鉴定需要。方法①观察原鉴定为须癣毛癣菌菌株在沙氏培养基、1%蛋白胨培养基、溴甲酚紫乳固体葡萄糖琼脂培养基(BCP-MSG)和显微镜下形态学及尿素酶、毛发穿孔等生理学试验表现。②通过ITS区段和LSU区段分子生物学序列分析进行新的分类系统的菌种分型,并对传统形态学和生理学鉴定方法进行检测。结果①41株须癣毛癣菌形态学及生理学试验符合须癣毛癣菌(38株)和红色毛癣菌(3株)菌落的特点。②ITS区段序列分析发现ITS区段能将须癣毛癣菌和红色毛癣菌准确的鉴定到种,但无法明确其种内分型;而LSU区段序列分析可对36株(36/38)须癣毛癣菌有性型做出明确的鉴定。结论传统实验室鉴定方法仍具有其有效性及可靠性。通过分子生物学鉴定,临床分离的须癣毛癣菌皆为指(趾)间毛癣菌(38/38),而LSU区段的序列分析鉴定狐狸源性菌株皆属于本海姆节皮菌,有别于大多数人源性菌株有性型为万博节皮菌,对于须癣毛癣菌的菌种鉴定更优于ITS区段,但分子生物学试验还需结合形态学的观察,才能够对菌种做出正确的鉴定。     

Aberrant development of Trichophyton mentagrophytes hyphae cultured in the presence of Congo red

When Trichophyton mentagrophytes colonies were placed on a medium containing 150 micrograms/ml of Congo red, a dye which prevents chitin fibrillogenesis, their growth rate was reduced. The newly formed mycelium, examined under an ultraviolet microscope, consisted of thick, curled and branched hyphae endowed with swollen tips and subapical bulges. Short-time exposure revealed that the major sites of dye accumulation were the extension zones. Normally structured hyphae arose from aberrant mycelia when they were transferred onto a dye-free medium. The phenomena observed suggest that Congo red alters the wall properties of the extension zone, by inhibiting the gradual conversion of chitin chains, synthesized at the extreme tip, into microfibrils of increasing size and density.     

三种抗菌织物对红色毛癣菌和须癣毛癣菌生长抑制效应的实验研究

目的通过分析汉麻织物、含纳米银锦纶纤维织物和无机银抗菌整理后棉布对红色毛癣菌、须癣毛癣菌生长的影响,探讨抗菌织物对皮肤癣菌的抑制作用。方法制备红色毛癣菌、须癣毛癣菌的菌悬液,分别接种于上述抗菌织物,并紧贴在PDA培养基表面培养,每12 h观察菌落形态及大小,根据菌落平均直径绘制生长曲线。结果三种抗菌织物上24 h内均未见菌落生长。①汉麻布样上,红色毛癣菌和须癣毛癣菌菌落直径分别在36-84 h、36-72 h时间区间内小于棉布组,差异有显著性（P〈0.05）,之后与棉布组渐趋一致。②含纳米银锦纶织物上,在36-108 h内红色毛癣菌菌落直径小于棉布组,差异有显著性（P〈0.05）,120 h时已无显著差异（P〉0.05）,须癣毛癣菌在48 h后才开始生长,在60-108 h区间内菌落直径小于棉布对照（P〈0.05）。③无机银抗菌整理后棉布样上,红色毛癣菌和须癣毛癣菌分别在48 h和60 h后才开始生长,在120 h以内两种皮肤癣菌菌落直径均小于棉布组,差异有显著性（P〈0.05）。结论三种抗菌织物与棉布相比较,在一定时间区间内,均可显著抑制红色毛癣菌和须癣毛癣菌的生长,尤其是经无机银抗菌整理后棉布的抑菌更有效和持久。     

Carotenogenesis associated with arthrosporulation of Trichophyton mentagrophytes.

Carotenoid pigments were demonstrated in arthrospores of the dermatophyte Trichophyton mentagrophytes but were absent from hyphae and microconidia of this fungus. Incubation at higher temperatures (39 degrees C) allowed arthrosporulation to occur, but essentially no carotenoid was detected in such arthrospores. The carotenoid formation in arthrosporulating T. mentagrophytes did not appear to be either induced or stimulated by light illumination. Mature arthrospores contained the carotenoids phytoene, phytofluene, zeta-carotene, neurosporene, lycopene, and gamma-carotene and a few minor unidentified carotenoids. These carotenoids were localized within intracellular granules consisting of osmiophilic matrices and complex membranous elements. This is the first demonstration of carotenoid pigments in dermatophytic fungi.     

甲真菌病体外模型研究

目的 构建一个简单、经济的新的甲真菌病体外模型.方法 制备猪甲板,在其腹侧面中央黏贴一个“O”型圈,将受试菌液加入“O”型圈内,将甲板放置培养皿中培养,用大体观察及组织病理的方法动态观察不同真菌侵袭甲板的情况.结果 用猪甲板制备甲真菌病体外模型,通过该模型观察了红色毛癣菌、须癣毛癣菌以及白念珠菌穿透甲板的能力.通过组织病理学方法观察到了真菌动态穿透甲板的过程.结论 该模型适用于评估真菌对甲板的致病作用.     

Antifungal activities of the essential oils in Syzygium aromaticum (L.) Merr. Et Perry and Leptospermum petersonii Bailey and their constituents against various dermatophytes

This study was carried out in order to investigate the potential of using plant oils derived from Leptospermum petersonii Bailey and Syzygium aromaticum L. Merr. Et Perry as natural antifungal agents. The antifungal effects of essential oils at concentrations of 0.05, 0.1, 0.15, and 0.2 mg/ml on the dermatophytes Microsporum canis (KCTC 6591), Trichophyton mentagrophytes (KCTC 6077), Trichophyton rubrum (KCCM 60443), Epidermophyton floccosum (KCCM 11667), and Microsporum gypseum were evaluated using the agar diffusion method. The major constituents of the active fraction against the dermatophytes were identified by gas chromatography-mass spectrometry and high-performance liquid chromatography analysis. The antifungal activities of S. aromaticum oil (clove oil) against the dermatophytes tested were highest at a concentration of 0.2 mg/ml, with an effectiveness of more than 60%. Hyphal growth was completely inhibited in T. mentagrophytes, T. rubrum, and M. gypseum by treatment with clove oil at a concentration of 0.2 mg/ml. Eugenol was the most effective antifungal constituent of clove oil against the dermatophytes T. mentagrophytes and M. canis. Morphological changes in the hyphae of T. mentagrophytes, such as damage to the cell wall and cell membrane and the expansion of the endoplasmic reticulum, after treatment with 0.11 mg/ml eugenol were observed by transmission electron microscopy (TEM). At a concentration of 0.2 mg/ml, L. petersonii oil (LPO) was more than 90% effective against all of the dermatophytes tested, with the exception of T. rubrum. Geranial was determined to be the most active antifungal constituent of L. petersonii oil. Taken together, the results of this study demonstrate that clove and tea tree oils exhibited significant antifungal activities against the dermatophytes tested in this study.     

Morphogenic effects of ramihyphin A in filamentous fungi

Ramihyphin A at subfungistatio concentrations stimulates ramification of hyphae of filamentous fungi. Stimulation of terminal ramification of hyphae that can be observed particularly in phytopathogenic fungi is most frequent. Hyphae ofMicrosporon canis, Trichophyton mentagrophytes, Blastomyces dermatitidis, Coccidioides immitis andHistoplasma capsulatum ramify intensively laterally. Stimulation of the lateral ramification was observed inMonilia fructigena, Penicillium marneffei andPenicillium chrysogenum. The antibiotic induces also formation of vesicular structures in phytopathogens. Due to the substantial ramification of hyphae, both terminal and lateral, the growth of colonies is interrupted. The addition of the antibiotic to a growing colony ofBotrytis cinerea induces dichotomic ramification of terminal hyphae after 3 h of growth. Lateral hyphae begin to grow later and further ramify dichotomically. Dense bundles of ramified hyphae are formed after 24 h due to the unbalanced ramification and the colony no longer increases its size.