着色真菌monophora引起皮肤着色芽生菌病1例

目的报道1例由着色真菌monophora引起的皮肤着色芽生菌病。方法取皮损皮屑标本进行真菌直接镜检和培养,同时取活检进行真菌培养和组织病理学检查。对真菌培养阳性菌株进行形态学鉴定、温度试验和放线菌酮耐受试验,PCR扩增测序。结果KOH涂片检查可见较多圆形厚壁棕色硬壳细胞。组织病理学显示为慢性肉芽肿样改变;PAS和银染色可见到圆形厚壁的硬壳细胞。真菌菌落生长缓慢,呈橄榄色到黑色。小培养可见大量棕色菌丝、分支分隔,分生孢子梗主要为喙枝孢型,分生孢子棕色,椭圆形或卵圆形,单细胞。温度试验37℃生长,38℃不生长。0．01％、0．05％和0．1％放线菌酮均能耐受。扩增真菌rDNA的ITS区得到645bp的片段,经序列分析与裴氏着色真菌monophora变种ITS区比对,100％一致。结论据真菌学形态结构特征以及DNA序列分析菌种被鉴定为着色霉monophora。     

裴氏着色霉致着色芽生菌病1例并文献复习

报道1例裴氏着色霉致左手背及腕部着色芽生菌病,通过文献复习统计并分析该病在我国的流行病学及临床特点.患者男,48岁,左手背部红斑、疣状增生伴瘙痒10 a.皮损组织病理检查示真皮中下层有炎细胞及多核巨细胞,PAS染色见硬壳小体.经真菌培养和分子鉴定为裴氏着色霉.经伊曲康唑600 mg每日口服,治疗3个月后好转.     

裴氏着色芽生菌病1例

1临床资料 患者男,60岁,农民。左下肢皮肤瘢痕、斑块11 a。11 a 前,不慎跌倒擦伤左膝下方皮肤,局部溃烂长期不愈。口服抗生素,外用碘伏,红霉素软膏治疗后无效,当地医院按真菌感染先后予口服伊曲康唑,氟康唑,特比萘芬不规则治疗,期间皮损大部分愈合形成瘢痕。其后瘢痕逐渐扩大并时有疼痛。后又在当地医院按“瘢痕疙瘩”予复方倍他米松注射液局部封闭治疗2次,瘢痕未缩小却在边缘渐出现红色斑块,肿胀并有浸润。遂来我院就诊。     

伊曲康唑联合全厚皮片移植术治愈着色芽生菌病1例

患者男,47岁.颈部皮损5a,皮损直接镜检可见多个棕色硬壳小体,皮损组织真菌培养为卡氏枝孢瓶霉,皮损组织病理PAS染色可见棕色厚壁孢子.诊断为着色芽生菌病,给予患者口服伊曲康唑胶囊治疗8个月,皮损形成瘢痕,之后采取全厚皮片移植术切除瘢痕,术后继续口服伊曲康唑治疗2个月,皮损痊愈.     

伊曲康唑联合特比萘芬治愈着色芽生菌病1例

报告1例由卡氏枝孢瓶霉引起的着色芽生菌病。患者男性,43岁,因右上臂局限性红色斑块性皮损5 a就诊。皮损组织病理为慢性炎性肉芽肿改变,可见硬壳细胞。真菌培养鉴定为卡氏枝孢瓶霉。给予伊曲康唑(200 mg/d)和特比萘芬(250 mg/d)联合治疗12周痊愈。     

硬壳小体形态多样性的着色芽生菌病1例并文献复习

报道1例由着色霉属引起的着色芽生菌病,患者耳部皮损KOH涂片镜检发现除成簇的硬壳小体外,还伴萌芽的硬壳小体和大量暗色菌丝。此镜检发现临床较为少见,易误诊为暗色丝孢霉病。以"着色芽生菌病""硬壳小体""萌芽/芽生"和"暗色菌丝"等作检索词检索PubMed、MEDLINE、中国生物医学文献数据库(CBM)、中国期刊全文专题数据(CNKI)、中国科技期刊数据库(VIP)及万方数据库等多个数据库,共检索到国内外相关文献6篇报道10例着色芽生菌病存在类似镜检发现。该文对相关文献进行复习,探讨硬壳小体形态多样性的现象,提高对着色芽生菌病的认识。     

着色芽生菌病致病机制的研究进展

着色芽生菌病是一种慢性皮肤和皮下组织肉芽肿性真菌病。该病发展缓慢,治疗困难,多数为皮肤受累。偶可伴有淋巴系统、脑组织等其他脏器受损及表皮肿瘤的发生。该文拟从微生物学、免疫学、分子生物学等方面对该病的致病机制进行综述。     

伊曲康唑治愈着色芽生菌病1例

着色芽生菌病（chromoblastomycosis）是由暗色真菌引起的皮肤及皮下组织的慢性肉芽肿性疾病。致病真菌常通过皮肤的微小外伤侵入,损害好发于四肢远端的暴露部位。临床表现为疣状增生性斑块或结节,病程持久,迁延不愈。最近我们用伊曲康唑治愈1例着色芽生菌病患者,报告如下。     

Fonsecaea monophora致皮肤着色芽生菌病1例

报告重庆地区1例由Fonsecaea monophora感染引起的皮肤着色芽生菌病。患者,男,81岁,因左上臂内侧皮肤被铁片划伤后出现溃疡伴疼痛1年余到我院就诊。对患者皮损组织行组织病理学检查和真菌培养,将培养出的菌落做形态学和分子生物学鉴定。真菌培养获得菌落形态,小培养乳酸酚棉兰染色得到镜下特征形态,菌落形态：可见暗棕色和黑色菌落生长;镜下形态：可见枝孢型和喙枝孢型产孢;皮损处组织病理学检查结果：可见慢性肉芽肿样改变。ITS(internal transcribed spacer)区域测序鉴定结果为Fonsecaea monophora。根据实验室培养结果和临床资料分析确定该例为Fonsecaea monophora感染引起的着色芽生菌病。口服伊曲康唑200 mg, 2次/日,联合药物涂抹和光动力学治疗有效。     

Fonsecaea monophora所致着色芽生菌病1例CSCD

患者,男,63岁,因“左手腕结节斑块半个月”为主诉就诊我科门诊。左手腕肥厚性的肉色斑块,结节,表面疣状增生,病理活检见真皮及多核巨细胞胞浆内褐色厚壁圆形硬壳小体。PAS染色(+),真菌培养见暗棕至黑色菌落生长;经测序,最终确诊为Fonsecaea monophora所致着色芽生菌病。予口服伊曲康唑治疗,但由于患者原发矽肺症状加重,后因矽肺引发并发症死亡。     

An ELISA test for the study of the therapeutic evolution of chromoblastomycosis by Cladophialophora carrionii in the endemic area of Falcon State, Venezuela

The purpose of this research was to evaluate an ELISA indirect method in patients with chromoblastomycosis caused by Cladophialophora carrionii. Samples collected before, during and postreatment with ajoene or itraconazole, and those from apparently healthy people from the endemic area were evaluated with the ELISA test. 94 individuals were studied, 10 with chromoblastomycosis, and 84 apparently healthy subjects. All of them were evaluated by clinical-dermatological examinations. On those with lesions suggestive of chromoblastomycosis, mycological studies were carried out to confirm the disease. This approach was repeated during and at the end of therapy. Five patients with lesions < or = 5 cms were treated with ajoene and five with lesions > 5 cms, received itraconazole. Mycological cure (60%) was similar in both groups of patients and persisted three months after therapy. One hundred and fourteen sera were analyzed by ELISA, 30 from 10 patients with chromoblastomycosis, before, during and postreatment and 84 from apparently healthy people, using a somatic antigen of C. carrionii (AgSPP). All patients with chromoblastomycosis were positive before-treatment, two became negative on day 45 of treatment and a total of six patients were negative three months post-treatment. All sera from apparently healthy individuals were negative. The sensitivity and specificity was 100% and 98.9%, respectively. The relationship between clinical-mycological studies and the ELISA assay was 100% before and after treatment. In summary, ELISA could be a valuable tool for the diagnosis and evolution of the therapeutic efficacy in patients with chromomycosis (C. carrionii). The use of an ELISA test is therefore highly recommended to establish remission criteria in chromoblastomycosis caused by C. carrionii.     

Phaeohyphomycosis caused by Cladophialophora bantiana

BackgroundCladophialophora bantiana is the most frequent cause of central nervous system phaeohyphomycosis.AimsWe report a case of phaeohyphomycosis by C. bantiana in a patient with underlying lung disease on steroid therapy.MethodsAn 81-year-old male was admitted in August 2011 with a history of difficulty speaking and deflection of the oral commeasure to the left side with a brain abscess. Brain tissue was cultured on Sabouraud media and sequence analysis of the internal transcribed spacer region of the ribosomal DNA was done for identification purposes. Susceptibility testing to various antifungal agents was performed using the microdilution test.ResultsHistopathological examination of the brain tissue ruled out malignancy and the presence of dematiaceous hyphae was observed. Culture showed the presence of a single black fungus, identified as C. bantiana. It was susceptible to all antifungals, except to caspofungin. The patient was treated with voriconazole plus liposomal amphotericin B. Cerebral cranial computed tomography [CCT] scans demonstrated persistence of the intraparenchymal abscess collection. Despite surgical and medical treatment with antifungal drugs, the patient died 5 months after the first diagnosis of the cerebral occupying lesion was made.ConclusionsPhaeohyphomycosis is an uncommon infection with severe limitations on the clinical clues that can help in early diagnosis. Fungal species identification is mandatory for epidemiological and therapeutic reasons. The MICs could be useful in selecting the appropriate antifungal agent. Avoiding the unnecessary exposure to soil or other media potentially contaminated with fungal spores should be recommended to any immunosuppressed patient.     

Global Spread of Human Chromoblastomycosis Is Driven by Recombinant Cladophialophora carrionii and Predominantly Clonal Fonsecaea Species

Global distribution patterns of Cladophialophora carrionii, agent of human chromoblastomycosis in arid climates of Africa, Asia, Australia, Central-and South-America, were compared with similar data of the vicarious Fonsecaea spp., agents of the disease in tropical rain forests. Population diversities among 73 C. carrionii strains and 60 strains of three Fonsecaea species were analyzed for rDNA ITS, partial β-tubulin, and amplified fragment-length polymorphism (AFLP) fingerprints. Populations differed significantly between continents. Lowest haplotype diversity was found in South American populations, while African strains were the most diverse. Gene flow was noted between the African population and all other continents. The general pattern of Fonsecaea agents of chromoblastomycosis differed significantly from that of C. carrionii and revealed deeper divergence among three differentiated species with smaller numbers of haplotypes, indicating a longer evolutionary history.     

我国首见斑替支孢瓶霉引起脑脓肿1例

目的报道1例斑替支孢瓶霉引起脑脓肿。方法抽取脑脓液作直接镜检和真菌培养,分离菌株行DNA序列分析、KOH耐受试验、温度试验和明胶液化试验。结果脑脓液直接镜检发现大量棕色、分隔或不规则膨胀菌丝,SDA培养出灰黑色、绒状、纽扣样菌落,微量培养可见棕色、单支或分支特长的孢子链结构,DNA序列分析属于斑替支孢瓶霉。菌株具有耐碱性,不能液化明胶,可在25-42℃环境下生长。脓肿穿刺术、两性霉素B脂质体静脉滴注和脓腔内注射等治疗无明显疗效,放弃治疗后死亡。结论根据其形态学特点和DNA序列分析,菌株被鉴定为斑替支孢瓶霉。该菌引起的脑脓肿为国内首例报道,脓肿穿刺术和单用两性霉素B治疗无明显疗效。     

Two human cases of tick bite caused by Ixodes nipponensis

We report two human cases of tick bite. A 63-year-old male had a pruritic pea-sized brownish nodule on the left popliteal area. Another 41-year-old male had an asymptomatic bean-sized black nodule in the pubic area. The ticks were identified as Ixodes nipponensis, which are the 18th and the 19th cases in Korea.     

两例IgM抗体激活补体引起ABO血型不合的探讨

为保障输血的安全可靠性,研究两例因补体激活引起的ABO正反定型不合,探讨抗体、补体与红细胞(ABO)血型的关系,运用免疫血型血清学方法,排除补体对ABO正反定型的影响,定出该两例血型为“O”型。