原发性皮肤黄曲霉病1例

报告 1例 5 6岁女性患者右小腿溃疡 2个月 ,经真菌学及组织病理学检查证实为原发性皮肤黄曲霉病。患者无免疫缺陷及相关基础疾病 ,经口服特比萘芬 2 5 0mg ,1次 /d ,共 3 5天治疗后痊愈。本文结合所报告的病例对皮肤曲霉病的分类标准、发病机制、病原菌及其治疗作了讨论与分析。     

Effect of Zataria multiflora Boiss. essential oil on colony morphology and ultrastructure of Aspergillus flavus

The mode of inhibitory action of Zataria multiflora Boiss. essential oil (EO) on the fungus, Aspergillus flavus, was studied by colony morphology examination, light microscopy, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The EO at concentrations used in this study suppressed the size of the colony as well as sporulation. SEM of mycelia treated with given concentrations of EO showed morphological alterations ranging from loss of turgidity and uniformity of mycelia at low concentrations of EO to evident destruction of the hyphae at higher concentration of EO. Semi-thin sections of mycelia exposed to different concentrations of EO were analysed by light microscopy and revealed that the major change at level as low as 50 ppm of EO was limited to vacuolisation of cytoplasm resulting in cell swelling, while at higher concentrations, detachment of the cell membrane from the cell wall, deformation of mycelia and shedding the cytoplasm from the cell were the main alterations. These damages were well documented by TEM, which showed that the main sites of action of EO were the plasma membrane and cell wall. In conclusion, morphological and structural changes observed in this study may be one of the mechanisms involved in growth inhibition of the fungi and reducing aflatoxin production.     

In vitro susceptibility of 188 clinical and environmental isolates of Aspergillus flavus for the new triazole isavuconazole and seven other antifungal drugs

Recently isavuconazole, an experimental triazole agent, was found to be active against Aspergillus species. As Aspergillus flavus is the second-most common Aspergillus species isolated from human infection and the fungus has not been widely tested against the drug, we studied a large collection of clinical (n = 178) and environmental (n = 10) strains of A. flavus against isavuconazole and compared the results with seven other Aspergillus-active antifungal agents (some of them triazoles, others echinocandins or polyene antifungals: voriconazole, posaconazole, itraconazole, caspofungin, anidulafungin, micafungin and amphotericin B) using Clinical and Laboratory Standards Institute methods. Strains with high minimal inhibitory concentrations (MICs) were tested by E-test as well. The strains were collected from two different geographical locations (India and the Netherlands). Three isolates (1.6%) had high MIC (2 mg l(-1) by microbroth dilution and 8 mg l(-1) by E-test) for amphotericin B. Isavuconazole showed good activity against A. flavus strains with MIC(50) and MIC(90) values of 1 mg l(-1). As compared with voriconazole (the drug recommended for primary therapy of aspergillosis), isavuconazole had better activity (99.5% of strains had MIC of ≤ 1 mg l(-1) for isavuconazole, compared to 74% of strains with same MIC for voriconazole). All strains were, following recently proposed clinical breakpoints, susceptible for the triazoles tested except three strains, which had MICs of 4 mg l(-1) for voriconazole. Testing these strains with high MIC by E-test, gave results of 0.5-2 mg l(-1). Posaconazole had the lowest MIC(50) and MIC(90) of 0.125 mg l(-1) and 0.25 mg l(-1), respectively. Among echinocandins, 97% of strains had a minimum effective concentration (MEC) of ≤ 0.5 mg l(-1) for caspofungin, and all strains had a MEC of ≤ 0.016 mg l(-1) and ≤ 0.125 mg l(-1) for anidulafungin and micafungin, respectively.     

仙龙抗癌胶囊薄层色谱鉴别

目的 :为控制仙龙抗癌胶囊质量。方法 :采用薄层色谱法对仙龙抗癌胶囊中蛞蝓、红参、三七、延胡索进行定性鉴别 ,其中蛞蝓的薄层色谱鉴别首次在制剂中发表。结果 :方法简单 ,阴性对照无干扰。结论 :可做为该产品质量的控制方法。     

HIV阴性儿童马尔尼菲篮状菌病2例临床分析并文献复习

 目的 总结2例人类免疫缺陷病毒（HIV）阴性儿童马尔尼菲篮状菌病（TSM）患儿的临床特征。方法 分析某儿童医院收治的2例HIV阴性TSM患儿的临床特点及实验室资料、存在的基础疾病,并复习相关文献,总结TSM感染患儿的临床特征及诊治经验。结果 2例HIV阴性TSM患儿中病例1以右下肢肿块为首发症状,1个月余后才出现发热及咳嗽,误诊为结核感染;病例2以发热、三系减少及肝脾、淋巴结大等表现起病。病例1行基因检测为STAT1基因突变,病例2有反复灰指甲及口腔溃疡病史,均行血、骨髓培养及淋巴结活检确诊。病例1先后予以伏立康唑、两性霉素B脂质体静脉滴注,伊曲康唑口服维持治疗,共治疗1年后停药;病例2一直予以伏立康唑治疗（先静脉滴注后口服）,共7个月后停药,均无复发。结论 TSM可发生在HIV阴性儿童,且可存在STAT1基因突变。对于治疗效果差的患儿,应尽早行培养或组织活检以明确诊断,并积极查找TSM可能存在的基础疾病,以到达早期诊断、早期治疗和改善预后的目的。     

Epidural mass due to aspergillus flavus causing spinal cord compression--a case report and brief update

Aspergillus infection of the central nervous system (CNS) is an uncommon disease. Most of the reported cases are of sinocranial spread and cases with contiguous spread to spinal cord from lung and other organs are uncommon. A case of pulmonary aspergillosis with extension to thoracic vertebrae forming a paraspinal mass resulting in neurological deficit due to Aspergillus flavus, is reported. The 43 year old patient did not have any obvious predisposing condition. He presented with loss of motor function and succumbed to the infection despite operative intervention and antifungal therapy. A brief update on CNS aspergillosis is presented along with detailed clinical, radiological and laboratory work up of the patient.     

Aspergillus flavus myositis in a patient after liver transplantation

Abstract:  We describe the first case of Aspergillus myositis caused by Aspergillus flavus in a liver transplant patient. The patient was a 43-year-old man who underwent liver transplantation because of end-stage hepatic cirrhosis. He experienced pain in his left calf two months after the operation. Nodules with weakness, swelling, and flaring were found in the calf two wk later. Color ultrasonic examination showed uneven resonance in the left gastrocnemius. Needle aspiration and biopsy of the muscle revealed septate hyphae consistent with Aspergillus species and focal necrosis of the muscle cells with inflammatory cell infiltration. A culture subsequently yielded A. flavus , confirming histopathologic diagnosis. Sequencing of the internal transcribed spacer region confirmed the morphologic identification. The patient was first given itraconazole 0.2 g twice daily for one wk and was then switched to terbinafine 0.25 g once a day. A three-month regimen of terbinafine therapy cured the infection, though the cultured fungus showed resistance to a number of antifungal agents. Aspergillus , a genus of ubiquitous molds, may cause invasive and even fatal disease in immunosuppressed patients.     

Cutaneous<Emphasis Type="Italic">aspergillus flavus</Emphasis> infection in a neonate

A premature newborn infant born at 30 weeks gestation developed erythematous papular skin lesions that coalesced to form a necrotic plaque with black eschar. Skin histopathology and culture demonstrated infection with Aspergillus flavus. There was no evidence of Aspergillus flavus infection elsewhere