厚皮马拉色菌引起面部疣状增生性结节一例

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。     

Asymptomatic Neurosyphilis

Lumbar puncture was performed in 18 patients with latent syphilis to rule out asymptomatic neurosyphilis. In seven patients the CSF findings were abnormal. The parameters used in CSF were cell count, total protein, immunoglobulins (IgG, IgA, IgM), IgG index, and serologic tests for syphilis (VDRL, Kolmer, RPCF and FTA-ABS, including monospecific IgG and IgM conjugates). In three patients, the CSF findings 7-10 months after treatment are also given. Penicillin levels in serum and CSF were determined in two patients after aqueous procaine penicillin G im with and without oral probenecid. The effect of blood contamination on the differentiation between normal and abnormal CSF may not be significant.