播散型孢子丝菌病

孢子丝菌病是申克孢子丝菌引起的皮肤、皮下及附近淋巴管的慢性结节或溃疡性病变。最早由美国的Baltimore报道了首例,1898年Schenck由上肢多发性脓肿中分离出病原菌,称为Sporotrichumsp．。1900年Hektoen和Perkins报道了第2例,将病原菌命名为SporotrixSchenckii。1920年西泽等报道了日本首例。1916年刁德信报道了我国首例。以后世界各国陆续报道,为世界性分布。     

孢子丝菌病

孢子丝菌病（sporotrichosis）是由孢子丝菌感染所致,主要引起皮肤感染,也可引起黏膜、骨骼甚或系统性病变。     

实验室确诊的孢子丝菌感染51例

孢子丝菌病由申克孢子丝菌感染而引起,由于一些医师缺乏对该疾病临床表现的认识及实验室检查手段的欠缺,易造成误诊。为了提高对该病的诊断率,减少因误诊给患者带来的痛苦,我们选择了2005年在外院误诊的病例51例,后经我院真菌实验室和病理室检查纠正原诊断的患者情况进行报道。     

鼻部固定型孢子丝菌病1例

报道1例猫抓后引起的固定型孢子丝菌病.患者男,16岁,皮损表现为鼻翼部位的增生物,其上覆有脓痂.临床上易与细菌感染混淆,但根据患者的病史、临床表现、病理、真菌镜检及培养诊断为申克孢子丝菌引起的孢子丝菌病.患者在应用7个月的碘化钾结合特比萘芬软膏外用治疗后,皮损完全消失.     

孢子丝菌病43例临床分析

目的 探讨孢子丝菌病的发病原因及特点。方法 就1991～2002年间在本院就诊的深部真菌病病例,利用沙氏真菌学检查方法筛查确诊为孢子丝菌病43例并进行临床观察。结果 1991—1993年患者5例（11．63％）,1994～1996年水灾后2年内患者34例（79．07％）,1997～2002年5年内患者4例（9．30％）。有明显外伤史及疑似蚊、蜂叮螫者占总发病人数72．09％。伴高血压者占20．93％。碘化钾治愈率100％。结论 各种原因造成的环境污染或某些自然灾害致使腐生菌大量生长繁殖是引起本病区域性流行的根本原因。外伤及昆虫叮、螫为重要致病条件。碘化钾为首选治疗药物。     

发生于双侧腰部的孢子丝菌病1例

1临床资料 患者女,29岁.6个月前无明显诱因其右侧腰部出现一黄豆大暗红色结节,触之较硬,表面逐渐出现结痂,无糜烂、渗液,未予治疗.皮疹逐渐增大,并在左右两侧腰部又相继出现多个类似结节,结节破溃并渗出脓液,伴轻微痒、痛.在外院行皮肤活检,拟诊“疣状皮肤结核”,抗酸染色阴性.于2011年1月10日来我科就诊.自发病以来无发热、胸腹疼痛及关节疼痛等不适.既往体健,否认结核、肝炎等传染病史及外伤史.各系统检查未见明显异常.皮肤科情况:双侧腰部可见多个散在分布的暗红色结节,黄豆至蚕豆大,界清,质稍硬,表面有少许鳞屑,部分破溃并可挤出脓液(见图1).     

固定型皮肤孢子丝菌病1例

1 资料与方法 1.1 临床资料 患者女,60岁。山东齐河人,在家务农。因右腕背侧斑块、红斑3个月于2003年1月就诊。患者3个月前在家砍树时被树枝刺伤,一周后伤处出现淡红色丘疹,斑丘疹,约绿豆大小,后逐渐增大,融合成斑块。表面有渗液、结痂,之后在斑块右侧出现红斑,偶痒,曾于多家医院就诊。给予抗真菌药、抗生素和皮质类固醇药物外用并抗过敏,抗结核治疗无效。     

皮肤型孢子丝菌病316例临床分析

目的探讨孢子丝菌病的临床特征及病理特点,指导临床实践。方法分析1972～2007年间就诊于我院的孢子丝菌病447例,其中有详细资料者316例,做皮肤组织病理检查的203例中,105例做了PAS染色检查。结果春季发病者占50．34％,临床分型以固定型略多（52．53％）。儿童主要以面部发病。主要病理改变为混合细胞性肉芽肿。PAS染色阳性率为38．1％。结论孢子丝菌病常年皆可发病,近几年有增多的趋势,春季为本病高发季节。儿童皮损主要在面部,多为固定型。病理改变多为混合细胞性肉芽肿。病理切片、PAS染色诊断阳性率不高,确诊主要靠真菌培养。     

孢子丝菌病的治疗及护理

目的探讨孢子丝菌病患者的治疗与各项护理方法的临床效果。方法对88例孢子丝菌病患者给予抗真菌药物治疗,同时给予预防感染及皮肤、心理、饮食等护理措施。结果痊愈29例(占32.9%),显效38例(占43.2%),好转16例(占18.2%),无效5例(占5.68%),总有效率76.1%。结论采用综合疗法治疗孢子丝菌病,获得疗程短、疗效佳的效果。     

沈阳地区孢子丝菌病48例临床分析

目的探讨孢子丝菌病的发病原因、特点、诊断及治疗。方法对48例孢子丝菌病病例进行调查分析,全部行真菌学检查,部分行病理检查,采用碘化钾、特比萘芬或以碘化钾为基础的联合治疗。结果48例患者有明确外伤史,蚊虫叮咬病史者占总发病人数66.67%。单纯应用碘化钾或以碘化钾为基础的联合治疗8~12周,治愈率均达100%。结论外伤及昆虫叮咬、动物抓伤为本病的重要致病诱因,单纯应用碘化钾或特比萘芬均可治愈,但联合用药起效更快,效果更好。     

Humoral immune response against soluble and fractionate antigens in experimental sporotrichosis

Sporotrichosis is a chronic granulomatous mycosis caused by the dimorphic fungus Sporothrix schenckii, which is widely distributed in nature, and presents a saprophytic mycelial form on plant debris and soil. The immunological mechanisms involved in the prevention and control of sporotrichosis are not yet fully understood. In this study, mice were studied after infection with Sporothrix schenckii. In the first week after infection, fungal loading increased and thence decreased drastically 14 days after infection. Analysis by immunoblotting showed that the sera of all mice tested had antibodies reacting only with a 70 kDa antigen, with predominance of IgG1 and IgG3. Taken together, our results show that antigens from S. schenckii induced a specific humoral response in infected mice.     

Oral potassium iodide for the treatment of sporotrichosis

Potassium Iodide is the antimycotic of choice for the treatment of cutaneous sporotrichosis, because of its efficacy, safety and low cost. We carried out a review of published studies on the benefits and adverse reactions of using SSKI (Saturated Solution Potassium Iodide) as treatment for sporotrichosis, but could not identify any well-designed clinical trails. There is an urgent need to conduct randomized double-blind placebo-controlled trials and critically assess usefulness of SSKI by using a standardize monitoring or an effective self-report system.     

A histopathological study of experimental murine sporotrichosis

Summary 1. A histologic study of experimental sporotrichosis in mice was carried out. The reaction of tissue and the structure of the tissue phase of the organism in untreated controls and in mice treated with amphotericin B and griseofulvin were compared.2. Considerable differences existed in the lesions and the number of organisms in the different organs; there was also variation in relation to the duration of the experiment.3. Hyphal elements in the tissue in experimental sporotrichosis were observed for the first time.The project was in part supported by Grant E-576 from the National Institutes of Health and the Brown-Hazen Fund.     

Prophylactic and therapeutic vaccines against sporotrichosis. Feasibility and prospects

Sporotrichosis is an emergent subcutaneous mycosis of humans and some animals caused by dimorphic fungi of the genus Sporothrix. The disease occurs worldwide but is endemic or hyperendemic in tropical and subtropical areas. The epidemiology of the disease is changing dramatically, and it is now considered an important zoonosis with high morbidity rates, principally in Brazil, and an opportunistic infection in immunocompromised patients. Due to the limited options currently available to treat invasive fungal infections, including sporotrichosis, and the emergence of drug resistance and toxicity, the development of anti-Sporothrix vaccines has become an area of great interest. This work provides a brief analysis of the feasibility of the development of prophylactic and therapeutic vaccines against sporotrichosis, the main advances achieved to date, future challenges and prospects.     

Disturbances in the production of inteleukin-1 tumor and necrosis factor in disseminated murine sporotrichosis

Production of Interleukin-1 (IL-1) and Tumor Necrosis Factor (TNF) by adherent peritoneal cells from BALB/c mice was measured at week 2, 4, 6, 8 and 10 after intravenous inoculation with 10⁶ Sporothrix schenckii yeasts. As compared with age-matched controls, IL-1 and TNF production by adherent peritoneal cells fromS. schenckii-infected mice was reduced severely at week 4 and 6 of infection and greater than normal at week 8 and 10. Moreover, between week 4 and 6 of infection there was a depression of delayed type hypersensitivity response to a specific whole soluble antigen, and an increase in fungal multiplication in the livers and spleens of infected mice. Thus, the deficits of cell-mediated immunity in mice with systemicS. schenckii infection may derive, in part, from impaired amplification of the immune response consequent to abnormal generation of IL-1 and TNF.     

冷冻联合碘化钾治疗鼻部固定型皮肤孢子丝菌病1例

该文报道1例固定型皮肤孢子丝菌病.患者女,51岁,农民,因鼻部结节2个月就诊,皮损表现为鼻尖部增生物,其上覆有黑褐色厚痂.根据病史、临床表现、组织病理、真菌镜检及培养诊断为固定型皮肤孢子丝菌病.经过3个月冷冻联合碘化钾口服治疗后,皮损完全消失.     

Diagnostic performance of mycologic and serologic methods in a cohort of patients with suspected sporotrichosis

BackgroundThe gold standard for the sporotrichosis diagnosis is culture; however, serologic approaches have been recently implemented to aid in the sporotrichosis diagnosis. Nevertheless, the clinical consequences of the introduction of serologic tests are poorly addressed.AimsTo correlate the results of culture and serology of patients with suspected sporotrichosis.MethodsA retrospective study of 198 patients with suspected sporotrichosis was conducted. Information about culture isolation of Sporothrix from clinical samples and antibody detection by an enzyme-linked immunosorbent assay (ELISA) were obtained from the medical records of the patients.ResultsPositive culture and antibody detection was observed in the samples of 84 patients (42.4%). Forty-one samples (20.7%) showed negative results with both techniques and divergent results were obtained in the samples of 73 patients (36.9%). False negative results in the ELISA were observed with 23 patients (31.5%), 78.3% of them with less than 30 days of infection (p = 0.0045). Among the initial false positive ELISA in the sera of 50 patients, four samples in culture yielded the growth of Sporothrix, and 27 improved with itraconazole. At the end of follow-up, a diagnosis of proven or probable sporotrichosis was established in 139 patients, and possible sporotrichosis in 11 patients. The treatment of the patients with probable sporotrichosis with antifungal drugs resulted in clinical cure for these individuals.ConclusionsThese two techniques are complementary in the diagnosis of sporotrichosis, making diagnosis and clinical decision more precise.     

Anti-depressive-like effect of monoterpene trans-anethole via monoaminergic pathways

Trans-anethole (ANE) is a monoterpene present in many aromatic plants, especially Pimpinella anisum (PA). In this regard, we previously reported the anti-depressant potential of PA. Here, we examined the anti-depressant activity of ANE and its possible mechanism in mice. In experiment 1, the animals received ANE (12.5–50 mg.kg ^-1) 60 min prior to forced swimming and open-field tests. In experiment 2, the animals received several receptor antagonists to assess the possible mechanism of ANE. The administration of ANE (25 and 50 mg.kg ^-1; p < 0.01 and p < 0.001, respectively) exhibited an anti-depressive-like effect in FST without any significant effect on animal locomotion(p > 0.05). Moreover, haloperidol(p < 0.001), SCH23390(p < 0.001), sulpiride(p < 0.001), ketanserin(p < 0.001), p-chlorophenylalanine(p < 0.001), WAY100135(p < 0.001), reserpine, (p < 0.001) prazosin(p < 0.001), and yohimbine(p < 0.001) inhibited the anti-depressive-like effect of ANE. Furthermore, co-treatment of a subeffective dose of ANE with imipramine or fluoxetine induced synergistic anti-depressant-like effects(p < 0.001). Our data mainly showed that the anti-depressive-like effect of ANE, which can be attributed to the contribution of the monoaminergic system.     

Motor behavior and brain enzymatic changes after acute lead intoxication on different strains of mice

Lead is a nonphysiological metal that has been implicated in toxic processes that affect several organ systems in humans and other animals. Although the brain generally has stronger protective mechanisms against toxic substances than other organs have, exposure to lead results in several neurophysiological and behavioral symptoms. The administration of a single injection (i.p.) of lead acetate in mice is a model of acute Pb2 + toxicity. In the present study, this model was used to explore the magnitude of the effect of different doses, time intervals and mice strains on several biobehavioral parameters. We investigated the effects of acute lead acetate administration on body and brain weight, brain lead acetate accumulation and specially, spontaneous locomotion and brain catalase activity. Lead acetate was injected i.p. in outbred (Swiss or CD1) and inbred (BALB/c, C57BL/J6 or DBA/2) mice at doses of 0, 50, 100, 150 or 200 mg/kg. At different time intervals following this acute treatment, several biochemical, physiological and behavioral responses were recorded. Results indicated that acute lead acetate has deleterious dose-dependent effects on brain and body weight. The effect on body weight in the present study was transient, although lead acetate was detected in neural tissues for several days after administration. Spontaneous locomotor activity only was reduced up until 24 hours. The effect of lead on body weight was strain-dependent, with Swiss mice showing greater resistance compared to the other strains. Total brain catalase activity in lead-pretreated Swiss mice showed a significant induction. This enzymatic upregulation could provide a protective mechanism for oxidative stress in these mice.