肺部及中枢神经系统尖端赛多孢子菌感染1例并文献复习

报道我院收治尖端赛多孢子菌致肺部及中枢神经系统感染1例,并探讨其治疗措施。取患者肺泡灌洗液、脑脊液、颅内引流物进行病原学培养及宏基因组二代基因检测,根据菌株的形态学特点和基因测序结果鉴定为尖端赛多孢子菌。手术引流及伏立康唑抗真菌治疗效果明显,但仍需进一步随访。     

浅谈尖端赛多孢子菌引起的侵袭性真菌感染

尖端赛多孢子菌（Scedosporiumapiospermum）即波氏假阿利什菌的无性型,是一种侵袭性较强的条件致病菌。1病因和发病机制尖端赛多孢子菌广泛分布于各种自然材料中,如沼泽、湿地、污水、腐物、咸水等。尖端赛多孢子菌感染多发生于艾滋病、器官移植、淋巴瘤、白血病、长期应用糖皮质激素或免疫抑制剂等免疫功能缺陷患者,也可发生于免疫功能正常者,如外伤、污水淹溺、HELLP综合征等。     

尖端赛多孢子菌所致肺部感染1例

报道1例吸入性肺炎合并尖端赛多孢子菌感染,并对其临床表现、真菌分离培养及生物学特性进行研究和分析。     

尖端赛多孢子菌真菌学及实验室研究进展

尖端赛多孢子菌是一种侵袭性和致病性较强的条件致病菌,可侵犯人体的多种器官导致多种疾病形式,并常引起致死性感染。现就尖端赛多孢子菌真菌学及实验室研究进展作一综述,以供临床参考。     

尖端赛多孢和多育赛多孢所致的深部真菌感染2例并文献复习

目的分别报道国内少见的由尖端赛多孢导致的化脓性关节感染伴骨髓炎和多育赛多孢的血行播散感染。方法取患者1的关节冲洗液和患者2的外周血标本直接涂片和真菌培养,根据真菌培养的菌落特点和镜下形态,鉴定致病菌种,并对分离的致病菌进行体外药敏试验。结果两个病例分别培养出尖端赛多孢和多育赛多孢。体外药敏试验显示两种菌对伏立康唑有较低的MIC值,而都对两性霉素B高耐。结论赛多孢菌的感染少见,且难治疗。应加深对少见真菌病的认识,提高诊治水平。     

多育赛多孢菌性鼻窦炎1例——致病菌的鉴定和体外抗真菌药物敏感性研究

目的报告国内首例多育赛多孢菌致鼻窦炎,并探讨致病菌的鉴定及其对抗真菌药物体外敏感性。方法取患者左侧上颌窦分泌物进行真菌培养和形态学鉴定,分离菌株β-球蛋白、rDNAITS序列分析确切鉴定,对分离菌进行7种抗真菌药体外药敏试验。结果根据菌株的形态学特点和基因序列结果鉴定为多育赛多孢菌。体外药敏试验显示该菌对7种抗真菌药物耐药。结论多育赛多孢菌所致的真菌病较少见,其确切鉴定靠形态学特征和基因分析。该菌株对多种抗真菌药物耐药。     

石膏样小孢子菌面部感染1例并文献回顾

报道1例由石膏样小孢子菌感染所致的面癣.患者为5岁男童,外伤后致右侧面颊部红斑、丘疹、脓疱20余日于我科就诊.真菌镜检显示菌丝阳性;真菌培养生长石膏样小孢子菌.皮损外用酮康唑乳膏两周后复诊,痊愈.随诊观察1个月未见复发.     

真菌性鼻窦炎38例临床分析

目的:通过对38例真菌性鼻窦炎的诊断、治疗过程的分析,提示本病的临床特点及治疗方法.方法:回顾分析1992年～2002年收治的38例真菌性鼻窦炎的临床资料.结果:38例中,8例采用传统Caldwell-lue手术、30例采用鼻内镜手术.术后病理证实为曲霉菌感染,术后随访2～3个月,术腔黏膜光滑,窦口引流通畅,无复发.结论:真菌性鼻窦炎近年来有增多趋势,有时与恶性肿瘤、慢性鼻窦炎难以鉴别.CT扫描有特征性改变,具有重要诊断价值.鼻内镜手术损伤小,保留功能,正逐渐替代传统手术.     

血液病患者合并阿萨希毛孢子菌菌血症3例并文献回顾

毛孢子菌属是一类有“念珠菌样”特征,在自然界广泛存在的一类条件致病真菌。该类菌可以引起人类皮肤浅部感染、过敏性肺炎,在免疫损伤患者中可引起侵袭性感染,其中阿萨希毛孢子菌在毛孢子菌属中最为常见[1]。恶性血液病患者由于免疫功能受损,长期接受化疗药物并易行静脉置管,是真菌感染的好发人群,有文献报道,毛孢子菌是引起恶性血液病患者播散性感染的除念珠菌属外第二位的酵母菌[2],死亡率可高达75%以上[3]。     

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.     

Toluene biofiltration by the fungus Scedosporium apiospermum TB1

The performance of biofilters inoculated with the fungus Scedosporium apiospermum was evaluated. This fungus was isolated from a biofilter which operated with toluene for more than 6 months. The experiments were performed in a 2.9 L reactor packed with vermiculite or with vermiculite-granular activated carbon as packing material. The initial moisture content of the support and the inlet concentration of toluene were 70% and 6 g/m3, respectively. As the pressure drop increased from 5-40 mm H2O a strong initial growth was observed. Stable operation was maintained for 20 days with a moisture content of 55% and a biomass of 33 mg biomass/g dry support. These conditions were achieved with intermittent addition of culture medium, which permitted a stable elimination capacity (EC) of 100 g/m3(reactor)h without clogging. Pressure drop across the bed and CO2 production were related to toluene elimination. Measurement of toluene, at different levels of the biofilter, showed that the system attained higher local EC (200 g/m3(r)h) at the reactor outlet. These conditions were related to local humidity conditions. When the mineral medium was added periodically before the EC decreases, EC of approximately 258 g/m3(r)h were maintained with removal efficiencies of 98%. Under these conditions the average moisture content was 60% and 41 mg biomass/g dry support was produced. No sporulation was observed. Evaluation of bacterial content and activities showed that the toluene elimination was only due to S. apiospermum catabolism.     

Assessment of biofilm formation by Scedosporium apiospermum,S. aurantiacum,S. minutisporum and Lomentospora prolificans

Reported herein is the ability of Scedosporium apiospermum, S. aurantiacum, S. minutisporum and Lomentospora prolificans conidia to adhere, differentiate into hyphae and form biofilms on both polystyrene and lung epithelial cells. To different degrees, all of the fungi adhered to polystyrene after 4 h, with a predominance of those with germinated conidia. Prolonged fungi–polystyrene contact resulted in the formation of a monolayer of intertwined mycelia, which was identified as a typical biofilm structure due to the presence of a viable mycelial biomass, extracellular matrix and enhanced antifungal resistance. Ultrastructural details were revealed by SEM and CLSM, showing the dense compaction of the mycelial biomass and the presence of channels within the organized biofilm. A similar biofilm structure was observed following the co-culture of each fungus with A549 cells, revealing a mycelial trap covering all of the lung epithelial monolayer. Collectively, these results highlight the potential for biofilm formation by these clinically relevant fungal pathogens.     

Rhinosporidiosis in Egypt: A case report and review of literature

Rhinosporidiosis is an infection caused by Rhinosporidium seeberi that frequently presents as a polypoidal nasal lesions. Here, we report the first indigenous case of tumoral rhinosporidiosis in Egypt. In this case, a 25-year-old male patient from a rural background of Assuit City presented with epistaxis and a nasal polyp. The patient had not traveled abroad. The diagnosis was established on the morphological basis by the identification of 5- to 10-m endospores and 50- to 1000-m sporangia. The clinicopathological and immunologic features were discussed and the literature was reviewed. To the best of our knowledge this is the first case of this disease to be reported in Egypt in the human literature.     

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。     

原发肾上腺淋巴瘤1例并文献复习

目的:探讨原发肾上腺淋巴瘤(PAL)的临床特点,提高对该病的认识.方法:对1例原发肾上腺淋巴瘤患者的资料进行分析,并结合国内外相关文献进行总结.结果:原发肾上腺淋巴瘤好发于老年男性,可表现为局部症状如腹痛,腰痛,也可表现为乏力,发热,体重减低等全身症状,50%病人可出现肾上腺功能不全的症状.一些病人是在行影像学检查时因偶然发现肾上腺的肿物,经病理检查而确诊的.该病多累及双侧肾上腺,最常见的病理类型是弥漫大B细胞型.原发肾上腺淋巴瘤的治疗包括手术、化疗、放疗以及它们的不同组合.该病恶性程度高,进展迅速,预后差.结论:原发肾上腺淋巴瘤虽然少见,但在肾上腺肿瘤,尤其是快速增长的肾上腺肿瘤的鉴别诊断中应考虑到它的可能,及时进行病理检查可尽早确诊.     

圣乔治教堂诺卡菌引起的肺部感染1例

诺卡菌肺部感染可引起肺诺卡菌病,因其无特异性的临床表现,容易误诊、漏诊。因此,临床实验室的培养鉴定能力非常重要,若不能及时诊治,则会导致病死率较高。诺卡菌病临床较为少见,为引起临床实验室对诺卡菌的鉴定和药敏试验的重视,本文报道了上海市嘉定区中心医院2019年2月收治的1例由圣乔治教堂诺卡菌(Nocardia cyriacigeorgica)感染引起的肺诺卡菌病病例,针对其临床特征、实验室检测及治疗等进行分析,期望对临床诊治诺卡菌病有所帮助。