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须癣毛癣菌所致脓癣病发的扫描和透射电镜观察及菌体外酶活性分析:2例报告
引用本文:刘艳,冉玉平,张瑞峰,代亚玲.须癣毛癣菌所致脓癣病发的扫描和透射电镜观察及菌体外酶活性分析:2例报告[J].中国真菌学杂志,2009,4(3):173-176.
作者姓名:刘艳  冉玉平  张瑞峰  代亚玲
作者单位:1. 四川大学华西医院皮肤性病科,成都,610041
2. 四川大学华西医院实验医学科,成都,610041
摘    要:目的报道2例由须癣毛癣菌引起的脓癣,并对病发做扫描和透射电镜观察及菌体外分泌酶活性测定。方法例1为6岁女孩,表现为头顶部炎性肿块、脓血伴脱发;例2为1岁8个月男孩,表现为头部红斑,无脓肿及脱发。家中分别饲养宠物狗和兔。病发真菌镜检均阳性后做真菌培养、生化鉴定及分子生物学鉴定。对2例患儿病发用扫描和透射电镜进行超微结构观察。对2株分离的菌株分别进行细胞外分泌酶测定。结果2株菌均鉴定为万博节皮菌(须癣毛癣菌的有性期)。扫描电镜见例1的病发受累毛干表面大量炎性组织碎屑、红细胞、脓细胞及上皮细胞;透射电镜在毛皮质内发现菌体。扫描电镜见例2的受累毛干表面真菌孢子及炎性渗出物;透射电镜见毛发内外菌体。2株菌的外分泌酶主要为碱性磷酸酶、白氨酸芳胺酶、β-葡萄糖甙酶、N-乙酰-葡萄糖胺酶、α-甘露糖甙酶。经口服伊曲康唑胶囊等综合治疗后2例均痊愈,未见不良反应。结论确诊2例须癣毛癣菌所致脓癣,伊曲康唑胶囊等药物联合治疗有效。

关 键 词:脓癣  须癣毛癣菌  扫描电镜  透射电镜  伊曲康唑

Two cases of kerion due to Trichophyton mentagrophytes:SEM and TEM observation of the involved hairs and analysis of secreted fungal enzymatic activities
LIU Yan,RAN Yu-ping,ZHANG Rui-feng,DAI Ya-ling.Two cases of kerion due to Trichophyton mentagrophytes:SEM and TEM observation of the involved hairs and analysis of secreted fungal enzymatic activities[J].Chinese JOurnal of Mycology,2009,4(3):173-176.
Authors:LIU Yan  RAN Yu-ping  ZHANG Rui-feng  DAI Ya-ling
Institution:1. Department of Dermatoverenology; 2. Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China)
Abstract:Objective To report 2 cases of kerion caused by Trichophyton mentagrophytes , observe the involved hairs under scanning electron microscope (SEM) and transmission electron microscope (TEM) , and determine the enzymatic activities of the i- solates. Methods Case 1 was a 6-year-old girl with scalp papules, abscess and hair loss. Case 2 was a 20 months old boy who had a region of erythema on his scalp. They had pet dog and rabbit respectively in the house. Hairs and scales before and after treatment were prepared for direct microscopic examination, culture and hair penetration test in vitro. The involved hairs were also observed under the SEM and TEM. The 2 isolates were identified by molecular biological methods and the enzymatic activities were determined with the semi-quantitative Api-Zym system. Results These two isolates were identified as Arthroderma vanbreuseghemii , the sexu- al form of Trichophyton mentagrophytes . Under SEM, many red blood cells, pus cells and exudation were found around the hair of case 1 and many spores around the hair of case 2. Under TEM, we found many fungi in the cortex of case 1 and fungi both inside and outside the hair in case 2. Semiuantitative analysis indicated multiple enzymes such as alkaline phosphatase, leucine arylamidase, N-acetyl-glucosaminidase, a-glucosaccharase and a-mannosidase. After oral itraconazole and topical treatment, both of the 2 children were cured without side effects. Conclusions Two cases of kerion due to Trichophyton mentagrophytes were diagnosed. Combination therapy was effective with good tolerance.
Keywords:kerion  Trichophyton mentagrophytes  SEM  TEM  itraconazole
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