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.     

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。     

鼻尖部固定型孢子丝菌病1例

1临床资料 患者男,42岁,吉林省柳河县农民。鼻尖红肿、结痂,逐渐加重,鼻头角化、增厚1个月。发病前40余日曾在种地喷农药时,反复擤鼻涕后抓土擦手、擦鼻子10余日。体格检查：发育、营养良好,心、肺、腹部及四肢均未见异常。皮肤科情况：鼻尖部拇指头大小的疣状增生物,基底呈暗红色,有轻度浸润,表面为黑褐色痂,粗糙不平,无自觉症状（见图1）。附近淋巴结未触及肿大,周边亦未见卫星状皮损。     

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。     

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。     

鼻部固定型孢子丝菌病10例临床分析

2006年1月～至2008年12月期间我院诊治了鼻部固定型孢子丝菌病10例,报告如下。     

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。     

1株多重耐药申克孢子丝菌感染的治疗

报道1例由多重耐药申克孢子丝菌引起的面部孢子丝菌病。患者61岁男性,面部皮疹2 a余,先后口服伊曲康唑、特比萘芬和氟康唑治疗16个月无效。患者皮损经真菌镜检和培养确诊为孢子丝菌病,分离的申克孢子丝菌体外药敏试验显示其菌丝相和酵母相对上述三种药物均不敏感。给予患者口服10%碘化钾溶液治疗3个月获得痊愈。     

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).     

难治性孢子丝菌病1例

报道1例因非医嘱习惯性口服激素导致的难愈性孢子丝菌病。患者右腕木屑刺伤后,出现局限性红斑伴破溃,曾多次外院就诊,诊断为“孢子丝菌病”,给予抗真菌治疗半年后病情仍不断恶化,遂来我院就诊。皮损经真菌镜检、培养及分子生物学测序均鉴定为孢子丝菌病,病理示感染性肉芽肿。询问病史时发现患者有日常口服激素的习惯,嘱患者停用激素并口服伊曲康唑4个月后治愈。     

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.     

Feline sporotrichosis: A case report

The isolation of Sporothrix schenckii from a female European cat it is described. The cat showed lengthened alopecic areas, with prominent nodules in the external surface of the thighs and abdomen. A mycological and histopathological studies of the lesions were carried out. The lesions resolved under treatment with 20% potassium iodide in doses of 0'1 ml/kg oral route in a 8 weeks period.     

Ultrastructure of Sporothrix schenckii treated with iodine-potassium iodide solution

The ultrastructural changes produced by iodine-potassium iodide solution on yeast cells of Sporothrix schenckii were investigated by transmission electron microscopy in order to clarify the mechanism of oral potassium iodide therapy for sporotrichosis. Yeast cells were dipped with solutions containing various concentrations of iodine. The rate of germination decreased markedly between the range of iodine concentrations from 0.63 g/ml to 5.0 g/ml. No significant ultrastructural changes were seen at the concentration of the iodine of 1.25 g/ml (80% germination) or less. In the concentration of 2.5 g/ml (50% germination), normal cells and degenerated cells coexisted. When the cells were treated with 5.0 g of iodine per ml (0% germination) or more, their interior structures were completely destroyed. It is assumed that iodine treatment of the organism causes rapid destruction in the whole cell.     

Determination of iodide using flow injection with acidic potassium permanganate chemiluminescence detection.

A simple and rapid flow-injection method is described for the determination of iodide, based on potassium permanganate chemiluminescence detection via oxidation of formaldehyde in aqueous hydrochloric acid. The calibration graph was linear over the range 1.0-12 x 10(-6) mol/L (r2 = 0.9955) with relative standard deviations (n = 4) in the range 1.0-3.5%. The detection limit (3sigma) was 1.0 x 10(-7) mol/L, with sample throughput of 120/h. The effect of interfering cations [Ca(II), Mg(II), Ni(II), Fe(II), Fe(III) and Pb(II)] and anions (Cl-, SO4(2-), PO4(3-), NO3-, NO2-, F- and SO3(2-)) were studied. The method was applied to iodized salt samples and the results obtained in the range 0.03 +/- 0.005 - 0.10 +/- 0.006 mg I/g were in reasonable agreement with the amount labelled. The method was statistically compared with the results obtained by titration; no significant disagreement at 95% confidence was observed.     

Effect of long-term injection of high doses of potassium iodide on iodine metabolism in rat thyroid gland

Concentration of thyroid hormones in the serum of the rats after 14-day injections of potassium iodide (1, 3, 10, 100, and 500 physiological daily doses) did not differ from the control values. Excessive administration of potassium iodide increased the total iodide content in the rat thyroid tissue by 60–121% (35–108% and 94–128% for the protein-bound and free iodide, respectively), indicating the activation of the uptake and organification of iodide. The long-term injection of both low and high doses of potassium iodide increased the activity of catalase by 8–18% and SOD by 33–50% and enhanced the level of toxic LPO products reacting with thiobarbituric acid by 15–38%. It is suggested that reactive oxygen species and the excessive iodination of proteins (particularly thyroglobulin) induced by the long-term administration of high doses of potassium iodide can play an important role in the development of thyroid dysfunctions and autoimmune diseases.     

Squamous cell carcinoma subsequent to scarring caused by sporotrichosis: A case report

BackgroundSporotrichosis is a fungal disease caused by the Sporothrix schenckii species complex. It is usually acquired by trauma with plants. Lymphatic-cutaneous is the most common clinical manifestation.Case reportThe present case describes the development of an epidermoid carcinoma as a late complication on a long evolution sporotrichosis scar. During a period of 50 years, the patient had lesions in the right hand. Sporotrichosis was diagnosed and treated with potassium iodide. Eleven years after the healing of the lesions, a squamous cell carcinoma on the scar of this mycosis was diagnosed.ConclusionsThe chronic sporotrichosis injury was probably the cause of the tumor developed on the scar.     

A morphometric study of the protective effect of cryotherapy on oral mucositis in cancer patients treated with 5-fluorouracil

We investigated cytological changes in oral mucosa smears from patients treated with cryotherapy to determine whether cryotherapy prevented mucositis caused by 5-fluorouracil (5-FU) therapy. Patients with gastrointestinal malignancies were divided into four groups; control patients before 5-FU therapy, patients after 5-FU therapy without cryotherapy, patients with cryotherapy before 5-FU therapy and patients with cryotherapy after 5-FU therapy. Oral mucosa samples from all patients were assessed at the beginning and on day 14 of chemotherapy. We used exfoliative cytology to evaluate cellular changes in the oral mucosa that were caused by 5-FU. Smears from each patient were stained using the Papanicolaou method and analyzed using stereology. Smears were taken from each group before and after 5-FU infusion. We found that nuclear volume was decreased significantly in cells of the 5-FU therapy after cryotherapy patients compared to the 5-FU therapy before cryotherapy patients. We also found significantly decreased cytoplasmic volumes in the 5-FU therapy after cryotherapy patients compared to the 5-FU therapy before cryotherapy patients. The results of cytomorphometric estimations revealed that cryotherapy may be used to prevent damage to oral tissue and may decrease the frequency and duration of oral mucositis caused by 5-FU.