球形孢子丝菌致婴儿固定型孢子丝菌病1例及相关实验研究

报道1例由球形孢子丝菌所致的婴儿固定型孢子丝菌病。患儿女，3个月，因左眼下内侧皮损2个月就诊，皮损脓液标本进行真菌培养，对培养获得菌株进行形态学、生理学和分子生物学鉴定，并进行药物敏感性检测。真菌培养阳性，镜下可见典型的套袖样菌丝。钙调蛋白基因序列分析鉴定为球形孢子丝菌。药敏试验显示特比萘芬和伊曲康唑对该菌株的菌丝相最低抑菌浓度（minimal inhibitorycon centration，MIC）分别为0．5μg／mL和0．5μg／mL；对该菌株的酵母相的MIC值分别为0．25μg／mL和0．5μg／mL。给予患者口服特比萘芬32．5mg／d治疗10周后皮损消退呈瘢痕化修复。依据临床及实验室检查确诊该病例为球形孢子丝菌所致固定型孢子丝菌病，特比萘芬治疗本病例显示较好疗效。

A case of infant fixed sporotrichosis caused by Sporothrix globosa and laboratory study

A case of infant fixed sporotrichosis caused by Sporothrix globosa was reported. A 3-month-old infant was admitted with skin granulomatous lesions beside the left medial canthus for 2 months. Direct smear examination and fungal culture, carbon source assimilation, PCR and calmodulin sequence analysis were performed for diagnosis. The antifungals susceptibility was tested according to M27-A3 and M38-A2 published by CLSI. Flower-shaped eonidia and sleeve-like hyphae were observed in the slide culture. Calm- odulin sequence were amplified, and the product was sequenced, which was aligned with 100% sequential similarity to multiple se- quences of Sporothrix globosa in the GenBank database. The MICs for terbinafine and itraeonazole were O. 5 μg/mL and 0.5 μg/mL against hyphae phage of the strain and 0.25 μg/mL and O. 5 μg/mL against yeast phage. The lesion was cured after oral terbinafine for 10 weeks. The case of fixed sporotrichosis was caused by Sporothrix globosa , terbinafine has good effect.