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1.
目的 探讨申克孢子丝菌基因差异、致病力与孢子丝菌病不同临床型别的关系。方法 ①收集不同临床型别孢子丝菌病的申克孢子丝菌分离株并提取DNA,进行随机扩增多态DNA(RAPD)扩增。②BALB/c小鼠接种不同临床型别孢子丝菌病的分离株菌悬液,观察实验动物发病及病变情况。③发病小鼠皮肤及内脏组织病理学检查,观察接种不同临床型别孢子丝菌病的分离株菌悬液后小鼠病变内申克孢子丝菌孢子数量及分布。结果 ①不同临床型别孢子丝菌病的申克孢子丝菌分离株聚合酶链反应产物电泳带型差异较明显:播散型分离株可见1800bp、850bp、500bp、180bp,皮肤淋巴管型分离株见1400bp、800bp、700bp、500bp,皮肤固定型分离株见2500bp、1400bp、1000bp、700bp。②注射播散型孢子丝菌病分离株菌悬液的BALB/c小鼠比注射皮肤淋巴管型分离株小鼠发病早、病变部位广且死亡率高;注射皮肤淋巴管型分离株的小鼠较注射固定型孢子丝菌病分离株小鼠皮损出现早、病变范围广且严重。③实验BALB/c小鼠病变皮肤及内脏组织病理学检查显示:注射播散型孢子丝菌病分离株的小鼠病变内孢子数量明显多于注射皮肤淋巴管型分离株小鼠病变内孢子数量,而后者较注射固定型孢子丝菌病分离株的小鼠病变内孢子数量多。结论 不同临床型别孢子丝菌病的申克孢子丝菌的基因差异、致病力与孢子丝菌病不同临床型别的关系密切。  相似文献   

2.
目的:对近年临床积累的孢子丝菌病例进行临床治疗总结分析。探讨菌子丝菌病的临床、组织病理特点,诊断及有效的治疗方法。方法:对门诊疑为皮肤孢子丝菌病的患者进行真菌学镜检培养和组织病理检查。对确诊病例进行治疗观察。结果:经临床和真菌学检查共25例皮肤孢子丝菌病,病理上按炎性浸润类型的不同,分4型。所有患者确诊后口服10%碘化钾溶液10nd每日3次,大多病例2至2.5个月治愈。结论:本病淋巴管型临床诊断不难,固定型因皮疹形似其他皮肤病易误诊,因此对慢性顽固难治的溃疡及可疑病例应作深部真菌检查培养及时明确诊断。该病治疗首选碘化钾,如单独口服碘化钾效果不明显或皮损面积较大者可考虑联合应用其他抗真菌药物及局部治疗或手术切除。  相似文献   

3.
孢子丝菌病是由申克孢子丝菌复合体感染皮肤、皮下组织、黏膜和局部淋巴系统所引起的慢性感染性疾病。临床表现多样,皮损主要表现为慢性炎症性肉芽肿损害。自1898年报道第一例孢子丝菌病后,对孢子丝菌病的认识越来越深刻,包括孢子丝菌病原体的变迁及其诊断和治疗方法的改进。病原体从申克孢子丝菌单一菌种到目前孢子丝菌复合体的认识。诊断方法包括真菌学检查、组织病理检查、孢子丝菌素以及分子生物学诊断;治疗方法包括碘化钾、伊曲康唑、特比萘芬、两性霉素B口服以及物理和手术疗法等。  相似文献   

4.
目的 利用探针与DNA印迹法对申克孢子丝菌进行种内分型,探讨其基因型特征与菌种来源及临床表现的关系.方法 CTAB法提取来源于不同地区31株孢子丝菌临床分离株及1株标准株的基因组DNA,以真菌通用引物ITS4、NS5扩增标准株的rDNA序列作为探针,与经限制性内切酶ApaI酶切后的基因组DNA进行印迹杂交.结果 杂交后形成多种清晰而稳定的带型,根据带型将31株孢子丝菌分为15种基因型(A-O型),其中A、B、C三型占51.61%.结论 探针与DNA印迹法是孢子丝菌种内分型较为敏感而可靠的方法,该方法所分基因型的不同与菌种的地区来源及临床表现有一定的相关性.  相似文献   

5.
孢子丝菌病是由申克孢子丝菌引起的常见深部真菌病,临床多见于淋巴管型及固定型,播散性孢子丝菌病少见.孢子丝菌进入人体后引起不同临床类型的孢子丝菌病与机体免疫状态有关[1],但是否与菌型有关尚无定论.为此,我们从一皮肤播散性孢子丝菌病患者皮损中分离1株孢子丝菌菌株,利用常规真菌学和分子生物学方法对其进行鉴定,并探讨该菌株与皮肤淋巴管型孢子丝菌在基因水平上的异同.  相似文献   

6.
目的 研究低治疗量碘化钾对孢子丝菌病发病的影响 ,为预防本病提供理论依据。方法采用含碘化钾的饮水饲养实验鼠 ,并设对照组 ,2周后行腹腔接种孢子丝菌 ,于接种后的第 3~ 8周 ,每周分批处死实验鼠 ,剖检 ,观察发病情况、病理学改变及真菌学所见。结果 实验鼠本病的发病率显著下降 (P <0 0 1) ,其下降与碘化钾的用量有关。结论 低治疗量碘化钾具有预防孢子丝菌病发病的作用。  相似文献   

7.
厚皮马拉色菌引起面部疣状增生性结节一例   总被引:1,自引:1,他引:0  
目的 报道1例由厚皮马拉色菌引起的面部疣状增生性结节。方法 采用真菌直接镜检与培养、温度试验、过氧化氢酶试验、皮肤病理检查、PAS染色和扫描电镜对1例面部疣状增生性结节女性患者分离出的菌株进行鉴定。结果 皮损病理检查显示真皮内慢性炎症细胞弥漫性浸润,PAS染色见真皮内散在的孢子。皮损和宠物狗皮屑革兰氏染色,镜检发现大量革兰氏阳性酵母样孢子及芽孢。含橄榄油及不含油SDA 27℃培养2周,见乳白色酵母样菌落生长。该菌在含油SDA培养,27℃生长最佳;过氧化氢酶试验阴性。扫描电镜观察显示菌体较小,芽颈较宽,基围较厚,孢子呈球形、卵圆形、椭圆形等形态。上述结果提示该菌为厚皮马拉色菌。结论 厚皮马拉色菌引起面部疣状增生性结节为国内首例报道,氟康唑联合局部冷冻治疗获得良好疗效。  相似文献   

8.
患者男,50岁。左上臂皮肤溃疡2年。皮损组织病理示:炎性肉芽肿改变,PAS染色可见圆形孢子和星状体。皮损真菌培养阳性,菌种鉴定为球形孢子丝菌。确诊为皮肤固定型孢子丝菌病,给予患者口服伊曲康唑和特比萘芬联合治疗3个月,皮损部分改善。之后患者间断口服特比萘芬联合碘化钾治疗,一年半后复诊仍有局灶性皮损未愈。  相似文献   

9.
我国首见由地霉引起的脓癣一例及实验研究   总被引:9,自引:3,他引:6  
目的 报道我国首见由地霉所致脓癣一例。方法 患者为9岁男孩,头部出现脓癣样皮损,耳后淋巴结肿大,全面临床检查排除其他疾病。取头顶皮损表面痂皮及病发多次真菌培养、直接镜检证实为真菌病;通过真菌培养、扫描电镜、生化学实验及DNA序列分析进行菌种鉴定;通过扫描电镜及毛发受侵试验观察菌株对毛发的感染情况;通过动物试验观察菌株的致病力;观察临床抗真菌治疗效果及体外药敏实验。结果 真菌学培养均有同样菌落生长,菌落表面平坦,27℃培养边缘有菌丝生长,37℃培养为湿润的酵母样菌落。镜下见大小不一的矩形关节孢子及大量圆形或卵圆形孢子,出芽或不出芽,并可见有分支的菌丝。菌种经生化学实验等鉴定为地霉菌,DNA序列分析证实该菌属于昔维考拉地霉(Geotrichum silvicola)或其姐妹株。动物实验证明该菌有致病性。经特比萘芬治疗4周后好转,真菌学检查阴性。结论 此例地霉所致脓癣为我国首见;特比萘芬治疗可以治愈。  相似文献   

10.
报告1例皮肤散播型孢子丝菌病。患者男,72岁。面部、躯干及四肢结节、溃疡5个月,发热、关节肿痛3个月。皮损组织病理呈感染性肉芽肿改变,PAS染色找到真菌孢子,组织培养见孢子丝菌生长。予碘化钾口服及萘替芬酮康唑乳膏外用,治疗5个月后皮损完全消退。  相似文献   

11.
Abstract:  Sporotrichosis in an uncommon mycoses in childhood and is generally associated with injuries received as a consequence of farm work. We undertook a retrospective study of sporotrichosis in children and adolescents seen over a 10-year period, focusing on their clinical, epidemiologic, and mycologic features as well as treatment. We included 25 children with a mean age of 9.3 years. Most of those affected were schoolchildren (84%) from rural areas. The main clinical variety of sporotrichosis seen was the lymphocutaneous form (64%), followed by the fixed cutaneous form (36%), and one instance of the disseminated cutaneous form. Most lesions were located on the upper limbs (40%) and the face (36%). Sporothrix schenckii was isolated in all patients and 24 of 25 had a positive sporotrichin skin test. Nineteen patients were treated and cured clinically and mycologically with potassium iodide, three were cured with itraconazole and one with heat therapy.  相似文献   

12.
The fixed cutaneous type of sporotrichosis is difficult to diagnose because clinical lesions are variable in appearance and the cells of Sporothrix schenckii are usually scarce in skin biopsy specimens. We have described two patients with lesions of fixed cutaneous sporotrichosis that resembled other inflammatory skin conditions and were treated with intralesional corticosteroids. Subsequent skin biopsies from these lesions demonstrated an unusually large number of yeast cells.  相似文献   

13.
【摘要】 目的 比较2010—2019年吉林大学第一医院确诊的儿童和成人孢子丝菌病的临床特征差异。方法 回顾性分析2010年1月1日至2019年12月31日吉林大学第一医院皮肤科3 124例孢子丝菌病患者的临床资料,其中儿童(< 18岁)911例,成人(≥ 18岁)2 213例。所有患者均经皮损真菌培养确诊为孢子丝菌病。采用χ2检验比较儿童与成人孢子丝菌病的临床特征差异。结果 911例儿童患者中,男女比例为1.4∶1,720例(79.0%)发生于寒冷季节(1 - 3月及10 - 12月),790例(86.7%)为皮肤固定型孢子丝菌病,835例(91.7%)皮损发生于面部。2 213例成人患者中,男女比例为1∶2.5,1 450例(65.5%)发生于寒冷季节,1 523例(68.8%)为皮肤固定型孢子丝菌病,1 090例(49.3%)皮损累及四肢,975例(44.1%)累及面部。儿童孢子丝菌病在寒冷季节发病的比例明显高于成人(χ2 = 55.55,P < 0.001),皮肤固定型孢子丝菌病比例亦显著高于成人(χ2 = 107.55,P < 0.001)。两组皮损分布差异有统计学意义(χ2 = 599.91,P < 0.001)。结论 儿童与成人孢子丝菌病的流行病学特征和临床表现存在差异。  相似文献   

14.
Cutaneous sporotrichosis, a subcutaneous mycotic infection is caused by the saprophytic, dimorphic fungus Sporothrix schenckii. It commonly presents as lymphocutaneous or fixed cutaneous lesions involving the upper extremities with facial lesions being seen more often in children. The lesions are polymorphic. The therapeutic response to saturated solution of potassium iodide is almost diagnostic. We describe a culture-proven case of cutaneous sporotrichosis of the face mimicking lupus vulgaris initially and basal cell carcinoma later, who did not tolerate potassium iodide and failed to respond to treatment with fluconazole. The patient had reactivation of infection following an infiltration of the scar with triamcinolone acetonide injection. Various other aspects of these unusual phenomena are also discussed.  相似文献   

15.
We report an epidemic of sporotrichosis in a south-east Queensland rural community. Sporotrichosis is a fungal infection due to the organism Sporothrix schenckii , typically presenting with cutaneous lesions. Sixteen cases of cutaneous sporotrichosis were seen over a 9 month period in the Darling Downs region of Queensland. All patients had had contact with a batch of mouldy hay presumed to be contaminated by Sporothrix schenckii . Nine of 16 patients were male; the youngest patient was aged 11 and the oldest was 67 years of age. Lymphocutaneous sporotrichosis was seen in 50% of patients; the rest demonstrated the fixed cutaneous form. No cases of disseminated cutaneous or systemic sporotrichosis were seen. One case demonstrated lymphangitis related to sporotrichosis. No apparent difference in the duration to diagnosis was demonstrated to exist between lymphocutaneous or fixed cutaneous types.  相似文献   

16.
Background Sporotrichosis is a chronic granulomatous infection caused by Sporothrichum schenckii. The disease has worldwide distribution. Majority of cases from India are reported from North‐eastern states. Methods The demographic, clinico‐investigative profile and therapeutic results of nine patients with cutaneous sporotrichosis attending the Dermatology Outdoor Department between January 2005 and June 2006 have been compiled. Results Out of nine (male‐4, female‐5) patients, five had lymphocutaneous‐type sporotrichosis while four had fixed cutaneous sporotrichosis. The average age of these patients was 40.8 years. The duration of complaints ranged from 1 month to 15 months (average 8.6 months). Two patients were able to recall traumatic injury. Six patients had lesions over lower extremities, two over face and one over upper extremity. Histopathologically, all cases showed granulomatous process with mixed inflammatory infiltrate comprising of lymphocytes, plasma cells, histiocytes and small neutrophil abscesses. Two cases were positive for fungal cells on PAS staining. Fungal culture on skin tissue was positive in all cases. Eight patients were treated with saturated solution of potassium iodide (SSKI) and they responded very well to SSKI in 12–16 weeks. One patient was pregnant and therefore was advised thermotherapy. Conclusion Sporotrichosis is also present in north‐western region of India as it is reported from north‐eastern part. This is the first series of cutaneous sporotrichosis being reported from Uttarakhand, a state situated in the north‐western region of India.  相似文献   

17.
Background Sporotrichosis is a subcutaneous fungal infection caused by a thermally dimorphic aerobic fungus, Sporothrix schenckii. It results from traumatic inoculation or contact with animals. Most cases were reported mainly in the tropics and subtropics. Objective The objective of our study is to assess the clinical characteristic of cutaneous sporotrichosis among our patients. Methodology We performed a retrospective review of all cases diagnosed with cutaneous sporotrichosis from July 2004 to June 2010. Patients’ medical records were retrieved and analyzed according to demography, preceding trauma, sites of lesions, clinical subtypes, treatment, and clinical response. Results Nineteen cases were diagnosed with cutaneous sporotrichosis with a male/female ratio of 9 : 10. Thirteen cases (68.4%) were able to recall preceding trauma, and seven of them reported cat scratches or cat bites. Lymphocutaneous sporotrichosis was observed in 13 cases (68.4%) followed by four cases of fixed cutaneous sporotrichosis and two cases of disseminated sporotrichosis. Histologically, 11 cases (57.8%) demonstrated a granulomatous reaction. Sporothrix schenckii was cultured in 12 cases (63.2%). Thirteen cases (68.4%) were successfully treated with oral itraconazole alone for a mean duration of 15.6 weeks. Two cases with disseminated cutaneous sporotrichosis were treated with intravenous amphotericin B. Conclusion Lymphocutaneous sporotrichosis was the most common subtype of cutaneous sporotrichosis in our series, with cat scratches or bites being the most common preceding trauma. Oral itraconazole was highly effective for the localized subtypes, whereas intravenous amphotericin B was required in disseminated cutaneous sporotrichosis.  相似文献   

18.
Thirty-seven cases of sporotrichosis, seen at the Royal Brisbane Hospital from 1965 to 1977, were reviewed. Twenty-eight of the patients were male. The Youngest was 11 and the oldest 80 years. Only four patients has the cutaneous lymphatic variety of sporotrichosis—the others had the localised cutaneous type. There were not cases of systemic sporotrichosis. The lesions in most patients were on the upper limb—mainly the forearm and hand. There was a variety of clinical appearances of the lesions. The most common being ulcerated lesions and verrucous plaques. Confirmation of diagnosis was by positive culture from scrapings or biopsy specimen and/or typical histology. Twenty-four patients were treated with potassium iodide mixture and 11 had the lesions removed surgically. Of the 18 patients followed up, 17 were considered cured.  相似文献   

19.
We report a 71-year-old Japanese healthy female with an unusual clinical course of sporotrichosis; she developed infectious lesions on the face and the left upper limb at different periods. The initial lesion appeared on her right cheek and nose in 1992. Histopathologic and fungal examinations comfirmed the diagnosis of sporotrichosis. She was treated with oral potassium iodide and/or itraconazole and topical heat therapy. She had three recurrences and her facial plaque, which was resistant to several conventional treatments, was eventually excised and then grafted in 1996. After the surgical procedure, oral medication was continued for two months. In 2001, new lesions appeared on her left hand and forearm, which were anatomically different from the former lesions. Based on histopathologic and mycological findings, we confirmed reinfection with sporotrichosis. She was again treated with potassium iodide. The cutaneous lesions completely resolved after 26 weeks without surgical treatment.  相似文献   

20.
皮肤型孢子丝菌病585例临床分析   总被引:2,自引:0,他引:2  
目的 对近3年吉林地区585例皮肤型孢子丝菌病病例进行总结,分析其临床和流行病学特征。方法 对2007-2009年我院皮肤科确诊的孢子丝菌病病例进行回顾性分析。结果 585例患者中男女比1 ∶ 1.35,平均年龄40.5岁,发病年龄以51 ~ 60岁最多见(22.05%);平均病程6.78个月;冬春季节发病者所占百分比最高;居住于农村者551例(94.19%),有外伤史者占25.47%。临床表现以固定型最常见(56.58%),其次为淋巴管型(39.66%),皮肤播散型和不确定型各占1.88%。受累部位以四肢(50.94%)及面部(43.76%)最多。治疗采用10%碘化钾溶液、伊曲康唑、特比萘芬或联合治疗。失访250例,余335例已治愈289例,平均疗程2.09个月,其余46例仍在治疗随访中。结论 孢子丝菌病近年来仍然是吉林地区的多发病,其临床及流行病学特点与以往报道相似,但中老年患者所占比例及皮损不典型病例增加,碘化钾、伊曲康唑和特比萘芬是治疗孢子丝菌病安全有效的药物。  相似文献   

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