幼儿两兄弟同时感染犬小孢子菌

报告两名幼儿同时感染犬小孢子菌。例1男,3岁,以左侧头顶部圆形红斑、丘疹、脓疱、脱发伴瘙痒3个月而就诊;头皮屑真菌镜检阳性,经培养鉴定为犬小孢子菌。例2男,5个月,为例1同胞兄弟;与例1同时出现两处面部红斑,边缘隆起、绕以炎性丘疹及脓疱,边界清楚,中心向愈,呈环形损害;常自行搔抓;刮取皮损处皮屑真菌镜检亦呈阳性,真菌培养亦为犬小孢子菌。最后诊断：犬小孢子菌病。     

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。     

面部带状疱疹后致孢子丝菌病1例

患者,女,54岁。右侧面颊部弥漫性红斑、丘疹、结节4个月。皮肤科查体:右侧面颊部弥漫性红斑,表面多个米粒至绿豆大的充实性丘疹、结节。真菌培养阳性,鉴定为球形孢子丝菌。诊断:孢子丝菌病。治疗:给予伊曲康唑0.1 g每日2次口服,治疗1个月后皮损较前明显好转。     

皮肤淋巴管型孢子丝菌病1例

报道1例皮肤淋巴管型孢子丝菌病。患者女,79岁,农民。左上肢皮肤红斑结节线状分布,疼痛瘙痒不适两月余。皮损病理及PAS染色提示真菌感染,对皮损和脓液进行真菌镜检,结果为阴性。真菌培养、小培养及对培养阳性菌落进行分子生物学鉴定提示申克孢子丝菌。诊断:皮肤淋巴管型孢子丝菌病。予口服伊曲康唑胶囊0.2g/次,2次/d,治疗1个月后明显改善。     

石膏样小孢子菌所致幼儿面部感染1例

报道1例由石膏样小孢子菌引起的面部体癣.患儿为2岁半幼女,因外伤后左面颊部出现浸润性红色斑块2个月就诊.初诊时考虑为孢子丝菌病,给予碘化钾内服1周无效.皮损在外用曲安奈德益康唑乳膏(派瑞松)2周后治愈.痂壳在接种沙堡弱培养基后20d后长出菌落,鉴定为石膏样小孢子菌.     

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.     

皮肤播散型孢子丝菌病1例并文献复习

目的探讨皮肤播散型孢子丝菌病发生的病因、临床特点、诊断及鉴别诊断,以提高对该病的认识,避免误诊、误治。方法对1例以声嘶为首发表现的皮肤播散型孢子丝菌病的临床资料、组织病理、真菌培养结果进行分析,并进行相关文献复习。结果患者以声嘶为首发表现,3个月后出现全身散在皮下结节。结节逐渐增多,部分破溃伴脓血。咽部组织病理示鳞状上皮黏膜急慢性炎伴上皮乳头状增生,可见多核巨细胞,抗酸染色未查出阳性菌。皮损处脓液真菌镜检及培养阴性。病理符合感染性肉芽肿。组织真菌培养见孢子丝菌生长。诊断为皮肤播散型孢子丝菌病。结论皮肤播散型孢子丝菌病在免疫正常人群发病时容易导致误诊误治;皮损表面脓液真菌镜检及培养阳性率低。病变组织真菌培养有利于得到阳性结果,早日明确诊断和治疗。     

儿童孢子丝菌病的临床分析及致病菌的基因型检测

目的 对吉林省扶余县35例儿童孢子丝菌病进行临床分析并对部分菌株进行基因测定,了解该地区孢子丝菌病的致病菌菌株基因是否发生变异而致致病力增强及发病率增高.方法 收集2011年1月1日～4月30日来自扶余县就诊于我科并确诊为孢子丝菌病的患儿35例,进行临床分析;从中选取8株菌,对其核糖体保守区及内转录间隔区(ITS)、非转录间隔区(NTS)区进行基因测定,了解基因水平上的异同.结果 8株孢子丝菌菌株中5株NTS区可见较大范围的碱基缺失.结论 吉林省扶余县孢子丝菌菌株可能由于NTS区碱基较大范围缺失而致致病力增强,导致该地区短时间内发病率增高.     

特比萘芬治愈儿童鼻翼孢子丝菌病1例

目的报道1例发生在4岁儿童鼻翼的孢子丝菌病。方法刮取病变组织接种到沙堡弱培养基培养,并对培养出的病原菌进行形态学鉴定和ITS区序列分析。结果病变组织在沙堡弱培养基25℃培养长出黑褐色菌落,25℃小培养后光镜及扫描电镜下见菌丝细长,分枝分隔,合轴式产孢形成的成簇和沿菌丝两侧排列,分生孢子卵圆形。提取真菌总DNA用PCR方法扩增ITS序列,测序后登录GeneBank进行比对,该菌与申克孢子丝菌菌株KMU3360ITS区碱基序列一致性达99%,鉴定为申克孢子丝菌。内服联合局部应用特比萘芬治疗6个月后皮损完全消退。结论确诊1例儿童鼻翼的孢子丝菌病,内服联合局部应用特比萘芬治疗儿童孢子丝菌病疗效良好。     

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.     

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。     

Crossover replantation and fillet flap coverage of the stump after ectopic implantation: a case of bilateral leg amputation

A successful case of crossover replantation of the left foot to the stump of the right leg and temporary ectopic implantation of the right amputated foot on the forearm is described. The ectopically implanted right foot was used as a free fillet flap for the late reconstruction of the left leg stump. At the latest follow-up examination, 18 months after the accident, the patient was able to walk independently with a prosthesis on the stump of the left leg. Both the cross-replanted foot and the free filleted foot flap, used for the reconstruction of the left leg stump, have maintained adequate protective sensation. The importance of utilization of amputated parts for functional reconstruction is stressed. Crossover replantations and ectopic implantations should be considered in bilateral amputations for the salvage of at least one extremity.     

The First Reported Case of Canine Subcutaneous Cryptococcus flavescens Infection

This report describes the first documented case of subcutaneous infection due to Cryptococcus flavescens in a dog. The chief symptoms of the patient dog were abscessed lesions on the dorsal muzzle, right eyelid, and lower jaw. Biopsy specimens from the lesions on the dorsal muzzle and lower jaw showed pyogranulomatous inflammation with numerous yeast cells. The patient dog was diagnosed with a subcutaneous fungal infection and orally received 5 mg/kg itraconazole once a day for 2 months, the abscesses disappeared. After 1 month at the end of treatment, the skin lesions did not redevelop. Isolates from the biopsy specimens were identified as C. flavescens by molecular analysis as well as morphologic and biochemical examination, indicating that C. flavescens is a potential canine pathogen.     

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。     

Unknown fixed cutaneous sporotrichosis

Sporotrichosis is the most frequent subcutaneous mycosis in Mexico. The clinical forms are commonly described as lympho-cutaneous and cutaneous-fixed. The case of a male patient who developed an eritematous plaque with radial growth is reported. The patient received empirical therapy and topic steroids which modified the clinical picture with vesicles to vesicles, ulcers and blood and honey crusts. Diagnosis of fixed cutaneous sporotrichosis incognito was established by clinical, mycological and histopathological studies. Delayed cellular immunity in vitro and in vivo were normal. The patient received oral itraconazole showing clinical and mycological cure after four months.     

Lymphocutaneous and nasal sporotrichosis in a dog from Southern Italy: Case Report

Sporotrichosis is a chronic, granulomatous and usually lymphocutaneous infection of humans and animals caused by the dimorphic fungus, Sporothrix schenckii. This study reports a case of lymphocutaneous and nasal sporotrichosis in a hunting dog with a three month history of non-healing skin lesions. Cytological examination of nasal discharge and of the material collected from ulcerated skin surfaces showed a few cigar-shaped organisms within macrophages. Fungal cultures of nasal and ulcerated skin swabs yielded colonies of S. schenckii. The dog received oral itraconazole but died of unrelated causes. Necropsic examination was not performed.     

Comparative Study on Biomechanics of Two Legs in the Action of Single-Leg Landing in Men’s Badminton

This study aims to analyze the biomechanical difference between the two legs of male badminton players when they land on one leg, thereby providing some guidance for preventing sports injury. Ten male badminton players were selected as the subjects. They did the single-leg landing movement successfully three times. The kinematic data were obtained by the Vicon infrared high-speed motion capture system. The kinetic data were obtained by the KISTLER three-dimensional forcing measuring platform. The data were processed and analyzed. The center of gravity of the right leg on the X and Y axes were 0.25 ± 0.05 and 0.21 ± 0.04 m, respectively, which were lower than that of the left leg (p < 0.05). At the moment of landing by a single leg, the hip angle of the left and right legs was 164.78 ± 6.12° and 156.29 ± 6.89°, respectively (p < 0.05), the hip joint speed of the left and right legs was 2.21 ± 0.32 and 1.98 ± 0.31 m/s, respectively (p < 0.05), the knee joint speed of the left and right legs was 2.51 ± 0.21 and 2.21 ± 0.21 m/s, respectively (p < 0.05). Although there was no significant difference in the range of joint motion, the motion range of the right leg was larger than that of the left leg, and the buffering time of the knee joint of the right leg was also significantly less than that of the left leg. The comparison of the kinetic data demonstrated that the ground reaction force (GRF), peak vertical ground reaction force (PVGRF), and lower limb stiffness of the right leg were significantly smaller than those of the left leg, and the time to peak force was greater than that of the left leg (p < 0.05). The injury risk of the left leg is greater than that of the right leg when the athlete land on a single leg. In the process of training, the athlete should strengthen the stability training of two legs, especially the left leg, in order to reduce sports injury.     

Sporotrichosis presenting as pyoderma gangrenosum

A 56-year-old female with an eight-year history of corticosteroid therapy for rheumatoid arthritis presented with large, deep, painful ulcers on the left buttock and thigh. The lesions appeared typical of pyoderma gangrenosum. Nine separate cultures of the exudate grew Sporothrix schenckii. During the course of iodide therapy, the patient expired due to Escherichia coli pneumonia. This is the third case report of sporotrichosis presenting as pyoderma gangrenosum and the first report from China.Sporotrichosis presenting as pyoderma gangrenosum is a special form of this disease. It develops quickly and must be treated promptly. Only two cases have been reported in the world literature. This is the first case reported from China.