Cutaneous Mucormycosis by Saksenaea vasiformis: An Unusual Case Report and Review of Literature

Mycopathologia - Saksenaea vasiformis is one of the numerous fungi of the Order Mucorales. Rapid progression and invasion of neighboring tissues are the most characteristic features of S....     

Stewart-Treves syndrome: Case report and literature review

Lymphangiosarcoma, or Stewart-Treves Syndrome (STS), is a very rare skin angiosarcoma with poor prognosis, which usually affects the upper limbs of patients who underwent breast cancer surgery, including axillary dissection followed by radiotherapy (RT). Cutaneous lymphangiosarcomas, which account for approximately 5% of all angiosarcomas, usually originate in the limb with chronic lymphedema. Lymphatic blockade is involved in the onset of STS. RT contributes indirectly to an increased risk of developing STS by causing axillary-node sclerosis and resulting in a lymphatic blockade and lymphedema. Chronic lymphedema causes local immunodeficiency, which indirectly leads to oncogenesis. Currently, axillary nodes are no longer routinely irradiated after axillary dissection, which is associated with a reduction in the incidence of chronic lymphedema from 40% to 4%. The use of sentinel lymph node biopsy technique is also widespread and the associated risk of lymphedema is further reduced. Thus, the incidence of STS decreased significantly with improved surgical and radiation techniques. The overall prognosis of STS patients is very poor. Only early radical surgical removal, including amputation or disarticulation of the affected limb, or wide excision at an early stage offers the greatest chance of long-term survival. Only a few case reports and series with a small number of patients with lymphangiosarcoma can be found in the literature. We present a case report of the first diagnosed STS at our department in an effort to highlight the need of the consideration of developing lymphangiosarcoma in patients with chronic lymphedema.     

Floral biology and pollination in stapeliads — new results and a literature review

The myiophilous pollination syndrome of stapeliads is investigated. Olfactory stimuli, imitating dung or decaying organic (zoogenic or phytogenic) matter, are used as attractants, together with mimetic colouration and, sometimes mimetic sculpturing. In most species nectar is present. The nectar mainly serves as optical attractant causing brilliance effects, and as visitor guide. However, nectar obviously is also a reward in many species. Flies (Cyclorrhapha:Calyptratae) constitute the most important pollinating group. In the pollination process they carry pollinaria only at the distal parts of their proboscis, never on their legs. No fundamental differences between the pollinator spectra of flowers in habitat and cultivated ones were observed.     

Ring chromosome 6: Case report and review of literature

Summary A ring chromosome 6 has been identified by GTG-banding in a male with microcephaly, growth retardation, seizures, epicanthus, hypertelorism, micrognathia, and other congenital anomalies. Cytogenetic studies indicate the instability of the ring chromosome. The most common findings in subjects with ring 6 include: profound to moderate mental retardation, microcephaly, prenatal growth failure, retarded bone age, epicanthal folds, flat nasal bridge, short neck, ears low-set or malformed, microphthalmia, and micrognathia. Linkage studies, including HLA, are consistent with reported maps of chromosome 6.This study was supported in part by grant number 1-442 from the National Foundation — March of Dimes     

Counterimmunoelectrophoresis and opportunistic fungal infections

Sera from 35 apparently normal humans, 37 compromised human patients, 30 hedgehogs and 30 sheep, were examined for precipitating antibodies to four opportunistic fungi — Absidia corymbifera, Aspergillus fumigatus, Candida albicans and Rhizopus arrhizus — using Counterimmunoelectrophoresis (CIE).Precipitins to A. fumigatus were almost exclusively confined to specimens obtained from the compromised human group (51% of those examined) while Candida precipitating antibodies were detected in the sera of both normal (26%) and compromised (49%) humans and in 10% of the hedgehog specimens. Serum precipitins against the two phycomycetes included in the investigations were rare.Because of the complexity of most fungal antigen extracts, it appears essential that sera be tested against a number of different antigen concentrations if CIE is to be used with confidence in fungal serology.     

Epidemiology of dermatophytoses in a rural community in Eastern Nigeria and review of literature from Africa

A total of 4,287 primary school children, comprising 1,740 males and 2,547 females in Arochukwu local government area of Abia state Nigeria were examined for clinical signs of dermatophytoses. About 873 (20.4%), consisting of 505 males and 368 females had lesions consistent with dermatophytoses. The disease was more prevalent in males (29%) than females (14.4%) in a ratio of approximately 2:1 (P < 0.05). The infection rate increased from 16.8% in the 4–6 year age group to a peak of 28.1% in the 10–12 year age bracket and dropped sharply to 5.6% in the 16–18 year group. The highest prevalence (39%) was observed among males aged 10–12 years while females 16–18 years had the lowest prevalence (2.5%). Tinea capitis was the predominant clinical type of dermatophytoses, and occurred in 13.7% of the total population studied and 67% of lesion positive cases. Trichophyton soudanense and Trichophyton tonsurans the predominant aetiological agents of dermatophytoses with a prevalence of 26.2% and 21.6%, respectively. Others include Trichophyton mentagrophytes (18.8%), Epidermophyton floccosum (8.3%), Microsporum audouinii (6.4%), Microsporum gypseum (6.0%), Trichophyton rubrum (5.5%) and Microsporum ferrugineum (7.3%), which was isolated for the first time in Nigeria.     

刺孢小克银汉霉原变种和轮生刺孢小克银汉霉变种(新组合)

刺孢小克银汉霉[Cunninghamella echinulata(Thaxt.) Thaxt. ex Blakeslce]是小克银汉霉属的模式种,多年来因不同作者是否将贝尼尔小克银汉霉(C. bainieri Naum.)包含在内而对此种持广义(sensu lato)或狭义(scnsu stricto)的不同理解。我们在国内分离到51株刺孢小克银汉霉(广义)菌种,经与获自css的7株菌(包括刺孢小克银汉霉的模式菌种在内)和IMI的1株菌(原定名称均为刺孢小克银汉霉)一起研究后,根据它们的无性型形态特征有明显不同但在配合试验中又可互相配合形成可育的接合孢子的结果,认为将它们处理为同一个种的两个不同变种较为合理.其中,13株中国的菌和3株CBS及IMI的菌被鉴定为刺孢小克银汉霉原变种(C. echinulata var. echinulata);其余的38株中国的菌和5株CBS的菌被鉴定为轮生刺孢小克银汉霉变种(新组合)[C. echinulata var. verticillata (F. S. Paine.) comb. nov.j.以‘轮生(verticillata)’作为新组合变种的加词是根据与贝尼尔小克银汉霉同物异名的‘轮生布拉小克银汉霉(C. blakesleeana var. verticillata (F. S. Paine) Baijal & B. S. Mchrotra)’而来的.在前人的工作中,对刺孢小克银汉霉持狭义理解的作者往往根据孢子枝的分枝方式、巨型暗色孢子的有无、以及40℃能否生长来区分这两个分类群.对刺孢小克银汉霉持广义理解的作者则认为这些特性毫无意义.我们同意后面两个特性意义不大,因为二者的许多菌系都能形成巨型暗色袍子并在40℃生长,但认为孢子枝分枝方式确实是区别这两个分类群的重要依据.此外,根据产孢构造的种类、孢子枝主枝的直径、孢子枝第一次分枝的数目、分枝长度、孢子枝主枝的顶生泡囊形状以及其直径等性状综合考虑,这两个分类群是不难明确区分的,对12株刺孢小克银汉霉原变种和13株轮生刺孢小克银汉霉相互之间所进行的配合试验结果表明,在具一定性亲和力的(+)、(一)菌系同时存在时,两个变种内和变种之间均可形成可育的接合孢子。对上述三种配合的各六对菌所形成的有性型形态的研究结果则表明,除轮生刺孢小克银汉霉变种内形成的接合孢子的壁往往较厚外,各种配合形成的有性型形态基本上是一致的.我们研究组的其他成员最近曾对小克银汉霉的22株菌进行了rDNA的ITS区的PCR产物长度测定,其中包括了刺孢小克银汉霉原变种和轮生刺孢小克银汉霉变种的各3株菌,它们的平均长度(bp)分别为890±7.5和915±7.6.这个结果也支持了我们在这两个分类群可以互相配合的情况下仍将它们作为两个不同变种的处理.这两个分类群虽然已被发表多次,但它们的描述和绘图均过于简单而未能充分显示出它们的区别性特征,因此我们在本文中再次作了描述并再次提供了详尽的线条图和显微照相.     

Prostate embryonal rhabdomyosarcoma in adults: Case report and review of literature

Introduction

Prostate embryonal rhabdomyosarcoma (ERMS) is a common tumour in infants and children, with a median occurrence age of 5 years, but it is rare in adults. It is characterized by a high degree of malignancy, both local rapid growth with formation of large pelvic masses, often leading to renal failure due to urethral obstruction, and systemic spread, commonly to the lungs, liver and bone. Several therapeutic approaches have been employed in the effort to treat prostate ERMS, but all of them have failed to gain a significant survival benefit in adult patients.

Case report

We report on a case of a stage IV prostate ERMS, approached with combined-modality treatment, with the administration of 5 courses of doxorubicin, ifosfamide and 2-mercaptoethane sulfonate sodium (mesna), and, subsequent radiotherapy to the prostatic bed (60 Gy/30 fxs). The patient remained free of progression of disease for about 1 year to finally experience a systemic relapse with multiple lung metastases and pleural effusion. The patient died for metastatic disease 27 months following the initial diagnosis.

Conclusion

While it remains questionable which therapeutic approach for prostate ERMS in adults is the most appropriate, our report demonstrates that a chemo-radiation combined treatment can control the prostate disease, reducing the symptoms and improving the quality of life of these patients, for the most part destined to die for systemic progression of disease.     

Pulmonary cryptococcosis in late pregnancy and review of published literature

Naturally occurring maternal immunosuppression increases the risk of infection by a variety of pathogens during pregnancy and the postpartum period. Pulmonary cryptococcosis during pregnancy is relatively rare. Here, we report on two cases of pulmonary cryptococcosis during pregnancy and puerperium. Both cases were successfully treated using oral fluconazole after parturition to avoid fetal toxicity. For the two patients, the placentas were checked and found to be pathologically normal, and the cryptococcal serum antigen in both infants was negative. Pulmonary cryptococcosis should be considered during differential diagnosis as a possible cause of abnormal chest shadow in pregnant patients.     

Central nervous system metastasis from osteosarcoma: Case report and literature review

Osteosarcoma is the most common primary malignancy of bone in children and young adults, the highest incidence peak is during adolescence and doesn’t have any gender predominance. The main site of metastasis are the lungs and extrapulmonary cases are occasional. The incidence of metastasis in the Central Nervous System (CNS) is 2–6.5%, increase to 10–15% in patients with pulmonary metastases. Therefore, metastatic disease of the CNS is rare and the information on such patients is limited. Here, we describe a case of a 20-year old patient diagnosed with osteosarcoma in the left distal femur stage IIB, he developed pulmonary disease, during palliative chemotherapy experienced relapse to the brain classified as recursive partitioning analysis (RPA) class II, and was treated with external radiotherapy (30?Gy in 10 fractions) and later he had a poor evolution and died.     

Treatment of deep mycoses with itraconazole

Four patients with deep mycoses were treated with itraconazole. Two patients had chromoblastomycosis, one patient each had aspergillosis and Rhinofacial zygomycosis. These patients were either resistant to or showed poor response to Amphotericin B and/or ketoconazole. After the initial clinical and mycological evaluation, itraconazole was given in a daily dose of 200 mg orally. All patients responded to the drug very well. No adverse effects attributable to itraconazole were detected.     

短梗霉感染文献回顾

短梗霉是一种在自然界广泛存在的暗色真菌,偶可引起人类感染,致病种有出芽短梗霉、黑色短梗霉、产酶短梗霉和曼氏短梗霉。临床表现多种多样,如真菌血症、腹膜炎、皮肤感染、脑膜炎、脾脓肿、肺炎、巩膜炎、角膜炎、淋巴结炎及甲真菌病等。短梗霉感染诊断较为困难,容易误诊。本文对Medline和中文文献数据库中的相关文献进行了系统查阅和分析,全面总结了短梗霉感染的地域分布、危险因子、临床表现形式、菌种类别、药物敏感性及其诊疗。     

前列腺泡沫状腺癌1例报告并文献复习

目的探讨前列腺泡沫状腺癌(prostatic foamy gland carcinoma)的临床病理特点、鉴别诊断、治疗及预后。方法观察1例前列腺泡沫状腺癌的组织学、免疫组化,并复习前列腺泡沫状腺癌相关文献。结果前列腺泡沫状腺癌的临床表现与经典型前列腺癌相似。镜下瘤细胞以其具有黄色瘤样胞浆为特征。核的异型性不明显,也常缺乏明显增大的核仁,但有结构异常、浸润性生长方式和基底细胞层消失。其假良性细胞学表现使之易被误诊为良性病变,或者使肿瘤的Gleason分级被低估。结论前列腺泡沫状腺癌是一种有侵袭性生物学行为的特殊组织学类型前列腺癌。     

Two new cases of cutaneous alternariosis with a review of the literature

Summary Two cases of cutaneous phaeohyphomycosis due to Alternaria tenuissima in patients affected with primitive myeloproliferative syndrome and lymphocytic lymphoma respectively are reported.Following a review of the specific literature, the authors discuss the etiopathogenic mechanisms, the clinical and histologic aspects of the lesions and the therapeutic problems.     

A case of cutaneous phaeohyphomycosis caused byExserohilum rostratum,its in vitro sensitivity and review of literature

A 40 year old woman presented with the infection of skin of 3 years duration on the upper anterior aspect of fore-arm. Histologic examination of the skin tissue revealed dematiaceous hyphae, aggregated structures or single celled elements. On detailed mycological examination the isolate was identified asExserohilum rostratum. Among the antimycotic tested in vitro amorolfine was found to be most effective with MIC value of 3 mcg/ml. This is the first report ofE. rostratum infection of man from India.     

水玉霉(Pilobolus)属的种的重新划分

我们在过去的工作中承认水玉霉(Pilobolus)属的9个种(郑、胡,见戴,1979)。近年来我们重新分离得到了这些分类群并对它们进行了再研究。研究结果表明,尽管它们是彼此可以互相区分的分类群,但是,包括我们过去的概念在内,目前被普遍接受的用于这个属的分类的种概念太小.为了与整个毛霉目的其它属的分类系统相一致,我们把这9个分类群重新划分为由9个变种组成的5个种:晶澈水玉霉原变种[Pilobolus crystallinu (Wigg.) Tode var. crystallinus],晶澈水玉霉透孢变种新组合[P. crystallinus var.hyalosporus (Boedijn) Hu &Zheng, comb. nov.],晶澈水玉霉克莱因变种新组合[P. crystallinus var.kleinii (van Tieghem) Zheng &G.-q. Chen, comb. nov.],豆状水玉霉原变种(P. lentiger Corda var. lentiger),豆状水玉霉小型变种新组合[P. lentiger var. minutus (Speg.) Zheng &G.-q. Chen, comb. nov.],长型水玉霉(P. longipes van Tieghem),厚壁水玉霉(P. Oedipus Mont.),露水玉霉原变种[P. roridus (Bolt.) Pers. var. roridus],露水玉霉突囊变种新组合[P. roridus var. umbonatus (Butler) Hu &Zheng, comb. nov.]。水玉霉属先后报道过的种或种下分类群名称共计50个左右,其中一些异名往往被不同的作者归到不同的正名下面。为了解决它们的正确归属问题,我们对全部原始描述作了细致的文献考证然后决定其位置。对那些找不到原始描述或从原始描述中得不出结论的则作为可疑名称处理。可疑名称共计12个:Mucor obliquus Scop., M. urceolatus Dicks.;Pilobolus urceolatus Purt., P. pestis-bovinae Hallier(=P. hallierii Rivolta), P. nanus van Tieghem, P. intermedius, (Coem.) P. A. Karsten(=P. Oedipus Mont. var,intermedius Coem.), P. pullus Massee, P.proliferens McVickar, P. ramosus McVickar, P. simplex McVickar, P. lentiger forma leinii Reyn. &Laysa, P. lentiger forma minutus Reyn. &Laysa.     

Complete monosomy mosaic of chromosome 21: Case report and review of literature

Complete monosomy mosaic of chromosome 21 is a rare disorder. The syndromic features are highly variable. This study describes a girl of Mexican origin with complete monosomy 21 in mosaicism with novel findings, including cortical atrophy, macrostomia, pectum excavatum and immune deficiencies. Parental karyotypes were normal. FISH analysis with probes from 21q22.1–q22.2 region and centromere of X DNA probe was performed on peripheral blood lymphocytes whereas 21q22.1–q22.2 and 21q, 4p, 4q subtelomeric DNA probes were tested in fibroblasts. We propose that the monosomy 21 mosaicism is the cause of the survival of children with more than 4 months of age.     

Prevalence and expression of enterotoxins in Bacillus cereus and other Bacillus spp., a literature review

Members of the Bacillus genus are ubiquitous soil microorganisms and are generally considered harmless contaminants. However, a few species are known toxin producers, including the foodborne pathogen, B. cereus. This species produces two distinct types of foodborne illness, the emetic (vomit-inducing) syndrome, associated with consumption of toxin in cooked rice dishes, and the diarrheal illness seen occasionally following consumption of contaminated meats, sauces, and certain dairy products. In the latter case, illness results from the production of enterotoxins by vegetative cells in the small intestine of the host. In dairy products, the occurrence of Bacillus spp. is inevitable, and the spore-forming ability of this organism allows it to easily survive pasteurization. Many strains have been shown to grow and produce enterotoxin in dairy products at refrigeration temperatures. Evaluation of toxin gene presence and toxin expression in Bacillus spp. other than B. cereus has not been thoroughly investigated. However, the presence of natural isolates of Bacillus spp. harboring one or more enterotoxin gene(s) and subsequent demonstration of conditions which may support toxin expression holds crucial importance in the food safety arena.     

复轮生暗孢小克银汉霉新变种及其与原变种之间的配合

多年前分离自湖北神农架林中采回的一份土样的一株小克银汉霉Cu137最近经我们研究定名为复轮生暗孢小克银汉霉新变种(Cunninghamella phaeospora Boedijn var.multiverticillata var. nov.)。它与暗孢小克银汉霉原变种(Cunninghamella phaeospora Boedijnvar. phaeospora)的异同在于:(1)两者均具有单轴分枝、分枝单生或成对的孢子枝,不同的是新变种的孢子枝除单轴分枝外还可轮状分枝,或单轴与轮状混合分枝,轮状分枝可多达3轮,每轮由3-8分枝组成,原变种则完全不形成轮状分枝;(2)两者的孢子枝主轴上的顶生泡囊均具各种形状并略呈棱角状,但新变种的侧枝上的饱囊常常是棒形的,原变种的侧枝上的饱囊则很少棒形;(3)新变种的假根很发达,可自菌丝、匍匐菌丝、孢子枝、泡囊等部位发生,而原变种的假根一般不很发达,而且只从菌丝或甸旬菌丝发生;(4)两者的小型孢子囊在形状、大小、刺等方面一致,但新变种的小型孢子囊无色至淡褐色,原变种的小型孢子囊则为淡褐色至深褐色;(5)新变种的菌落白色,至多在老后污白色至极浅的淡褐色,原变种的菌落自始即为深灰色。除暗孢小克银汉霉原变种外,同属中还有另外三个分类群与复轮生暗孢小克银汉霉较为接近:印度小克银汉霉(Cunninghamella indica Baijal & B. S. Mehrotra)与印度刺孢小克银汉霉[Cunninghamella echinulata(Thaxt.) Thaxt. ex Blakeslee var. indica Baijal & B. S. Mehrotra]因菌落白色及孢子枝分枝棒形,轮生小克银汉霉(Cunninghamella verticillaata Paine)因孢子枝具数轮轮生分枝而与复轮生暗孢小克银汉霉这个新变种有一定的相似。但是,新变种无论是顶生泡囊还是侧生泡囊的直径都较上述三个分类群小得多;新变种的顶生饱囊往往不规则形状且略带棱角,而上述三个分类群则不是这样。还有,新变种的孢子枝分枝方式与印度小克银汉霉的颇为不同,新变种的小型孢子囊比印度刺孢小克银汉霉的小得多,其小型孢子囊主要球形至近球形,与轮生小克银汉霉的椭圆形至卵形也不一样。此外,新变种的假根系统极其发达,与同属中任何一种均不相同。将复轮生暗孢小克银汉霉新变种Cu137(+)与暗孢小克银汉霉原变种的一株分离自香港山边土壤的Cu 136(一)配合时只形成配子囊,但与原变种的模式菌株CBS 692.68(-)配合时则可形成少量的接合孢子囊。为了获得更多的接合孢子囊以观察它们是否可育的,我们将Cu 137和CBS 692.68同时接种到许多培养皿上,然后制片观察。用姆指轻轻、重复压盖玻片,可使接合孢子囊破裂以观察其内含物。结果,从100个以上的接合孢子囊中,仅在其中4个发现有接合孢子的形成,其余的都是空的和不育的。由于原变种尚未发现(+)配合型菌株,新变种则未发现(-)配合型菌株,原变种与原变种之间及新变种与新变种之间配合形成的有性型尚未获得,而且全世界均未见有报道,无法和新变种与原变种之间配合形成的有性型相比较,因此目前尚不能肯定新变种与原变种之间形成的有性型在形态上是否能代表这个种的有性型。但是,尽管如此,暗孢小克银汉霉的这两个变种之间配合形成的有性型的形态仍然是很有特征性的,足以把它与其它种的已知有性型相区别。