葡萄孢佛隆那霉引起皮肤暗色丝孢霉病一例

患者女，16岁，左耳廓、面颊斑块3年。皮损取材真菌培养：沙氏葡萄糖琼脂培养基上菌落呈灰黑或灰褐色短绒毛状；马铃薯葡萄糖琼脂培养基小培养见分生孢子梗不分支或偶有分支，多芽合轴式产孢，分生孢子不分隔或有1 ~ 2个横隔，顶端钝圆，基底呈截断样；最适生长温度26 ℃ ~ 30 ℃，能液化明胶，水解淀粉。体外药敏实验对伊曲康唑、特比萘芬和两性霉素B敏感，对氟康唑耐药。组织病理检查见棕色菌丝和芽生孢子。PCR扩增ITS1-ITS4片段并测序，与基因库中葡萄孢佛隆那霉标准株序列比对，结果99%同源。诊断：葡萄孢佛隆那霉所致的皮肤暗色丝孢霉病。治疗：口服伊曲康唑胶囊100 mg每日2次，疗程约8个月，皮损逐渐消退。

Cutaneous phaeohyphomycosis caused by Veronaea botryose Ciferri et Momtemartini: a case report

A 16-year-old woman presented plaques on the left auricle and face over a period of 3 years. Fungal culture grew black-grey or dust velvety colony on Sabouraud's dextrose agar plate. A slide culture on potato dextrose agar plate showed conidiophores which were unbranched or occasionally loosely branched. The conidia were sympodial, zero- to two- septate, with rounded apices and truncated bases. The optimum growth temperature was 26℃ - 30℃. The fungus had the ability to liquefy glutin and hydrolyze starch. Anti-fungal susceptibility test showed the fungus was susceptible to itraconazole, terbinafine and amphoterecin B, but resistant to fluconazole. Cutaneous biopsy specimens revealed brown hyphae and budding yeast cells. The sequence of internal transcribed spacer (ITS) 1-ITS4 region of the isolate rDNA was assessed and compared against the Genebank databases. A 99% consistence was observed in the ITS sequence between clinical isolate and reference strain of Veronaea botryose Ciferri et Momtemartini. Based on the above findings, the mold was identified as Veronaea botryose Ciferri et Momtemartini. The lesions gradually subsided after 8-month treatment with oral itraconazole of 100 mg twice daily.