一株引起皮肤播散性孢子丝菌病的孢子丝菌临床分离株的基因型鉴定

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.     

申克孢子丝菌野生株致病性的实验研究

目的 研究申克孢子丝菌野生株的致病性。方法 制备申克孢子丝菌野生株的细胞悬液,注入小鼠体内,于接种后第1周开始至第10周,视发病情况每周分批处死、剖检,观察发病情况。结果 从自然环境中分离的申克孢子丝菌通过不同注射途径进入小鼠体内后均可导致小鼠致病;其产生色素的黑色菌株与不产生色素的白色菌株致病性无差异(P>0.05);腹腔组与尾静脉组比较致病性有差异(P<0.05).结论 申克孢子丝菌的野生株均具有致病性;黑白菌株致病性无显着差异;不同的致病途径致病性不同。     

种特异性引物鉴定申克孢子丝菌

目的 研究申克孢子丝菌的分子鉴定方法,为孢子丝菌感染的分子诊断奠定基础.方法 对22株申克孢子丝菌和12种12株暗色真菌临床分离株的核糖体DNA(rDNA)内转录间隔区(ITS)进行聚合酶链反应扩增.对10株来源于中国不同地区及1株来源于美国的申克孢子丝菌的扩增产物测序并进行分析,以获得的ITS2区序列为靶序列设计出申克孢子丝菌的种特异性引物(SSP),并用该引物扩增全部受试菌株.结果 序列分析显示,申克孢子丝菌rDNA的ITS2区相当保守,特异性引物对22株申克孢子丝菌可扩增出一条300bp的片段,其他受试菌株均为阴性.结论 应用设计出的种特异性引物,结合PCR方法,鉴定申克孢子丝菌特异、敏感、可靠,可用于临床诊断.     

阴囊孢子丝菌病1例及申克孢子丝菌基因型检测

孢子丝菌病是由申克孢子丝菌引发的一种皮肤、皮下组织和附近淋巴管的慢性感染性疾病,多发于四肢等容易暴露受伤的部位.本文报道1例发生于阴囊的固定型皮肤孢子丝菌病,并对申克孢子丝菌进行了形态学和分子生物学水平的鉴定.     

孢子丝菌病的治疗

孢子丝菌病( sporotrichosis)由双相真菌申克孢子丝菌(Sporothrix schenckii)感染所致,该病为最常见的深部真菌病之一,临床上分为固定型、淋巴管型、皮肤播散型和皮肤外型4种类型,其中前三种类型主要累及皮肤、皮下组织和淋巴管,皮肤外型罕见,主要发生于免疫抑制和免疫缺陷者,常累及肺、脑膜、骨关节和眼等,治疗困难,可危及生命.目前孢子丝菌病的治疗主要依靠药物,外科手术等可作为补充疗法. 一、常用的治疗药物和治疗方法     

申克孢子丝菌基因型与临床表现型关系研究

目的了解申克孢子丝菌的基因学特征，探索其基因型特征与临床表现型的关系。方法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，再用随机扩增DNA多态性方法（RAPD）进行PCR扩增。结果①共选用10个随机引物进行扩增，筛选出4个具有较好扩增片段的引物。②不同菌株同-引物扩增均见-共有DNA片段。③不同临床型孢子丝菌病的申克孢子丝菌分离株带型有差异。结论随机扩增DNA多态性研究发现申克孢子丝菌具有一定的种内差异，其DNA带型与菌株的临床型有关。     

利用核糖体基因进行申克孢子丝菌基因分型

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.     

应用PCR-RFLP进行申克孢子丝菌的分子生物学鉴定

目的　探索一种简单、快速的申克孢子丝菌的鉴定方法。方法　应用真菌通用引物ITS1和ITS4对来源于不同地区及不同临床型别孢子丝菌病的 2 8株申克孢子丝菌以及 9种其他临床上重要的真菌进行PCR扩增 ,利用限制性内切酶HaeⅢ对PCR产物进行酶切分析鉴定。结果　所有 2 8株申克孢子丝菌和其他 9种真菌均扩增出一条约 3 5 0bp的片段 ,其中 2 8株申克孢子丝菌RFLP带型一致 ,与 9种其他临床上重要的真菌RFLP带型差异较明显。 结论　PCR RFLP可以为建立一种简单、快速鉴定申克孢子丝菌的方法提供依据。     

皮肤淋巴管型孢子丝菌病1例

患者女,57岁。右拇指、腕部及前臂结节伴瘙痒和疼痛3月。右前臂皮损组织病理示:化脓性肉芽肿性改变。真菌培养见申克孢子丝菌生长。诊断:皮肤淋巴管型孢子丝菌病。     

申克孢子丝菌随机扩增 DNA多态性研究

目的 了解申克孢子丝菌的基因学特征,研究DNA分型与菌种来源和临床表现的关系。方法 以随机扩增DNA多态性方法对来源于不同地区及不同临床类型的24株申克孢子丝菌进行DNA多态性分析。结果 （1）筛选出3个具有较好扩增征段的引物,即引物OPAA11：5′-ACCCGACCTG-3′,OPD18：5′-GAGAGCCAAC-3′,OPBO7:5′-GGTGACGCAG-3′。（2）24株菌的DNA带型不完全相同,具一定遗传变异性。（3）不同菌株同一引物扩增均见一共有DNA片段,（4）播散型DNA带型与皮肤淋巴管型不同,结论 随机扩增DNA多态笥方法可用于申克孢子丝菌的DNA分型,其带型与菌株的地区来源和临床表现有关。     

A case of cutaneous disseminated sporotrichosis

We described a case of cutaneous disseminated sporotrichosis. The condition was diagnosed based on isolation and identification of Sporothrix schenckii from the lesions. The patient was otherwise normal, including a negative HIV test. The blood culture did not grow S. schenckii. However, spores were detected in the biopsy histological sections and stained positively with PAS staining and ConA and LCA lectin histochemistry.     

Epidemic cutaneous sporotrichosis: Report of 16 cases in Queensland due to mouldy hay

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.     

Cutaneous sporotrichosis. Intermittent treatment (pulses) with itraconazole

Sporotrichosis is a subcutaneous and exceptionally deep mycosis caused by a dimorphic fungus, Sporothrix schenckii. Itraconazole is a triazole derivative leading to good results in the treatment of sporotrichosis. Patients with cutaneous sporotrichosis proven with mycological tests (direct examination and culture) were enrolled. All patients underwent laboratory tests (at baseline and on a monthly basis) and received oral itraconazole 400 mg/day for one week with a 3-week break (pulses); thereafter the drug was administered as pulses until clinical and mycological cure was achieved. Five patients with sporotrichosis were enrolled, 4 with cutaneous lymphangitic form and one with fixed cutaneous form. Clinical and mycological cure was achieved in 4/5 cases (80%), with a mean number of pulses of 3.5. No patient had side effects and no laboratory test abnormalities occurred. Intermittent or pulsed itraconazole was effective in treating cutaneous sporotrichosis. It may be considered as a new treatment choice that entails an important reduction in total medication use.     

Epidemiological data and molecular characterization (mtDNA) of Sporothrix schenckii in 13 cases from Mexico

BACKGROUND: Sporotrichosis is an endemic mycosis in Mexico and Central America. OBJECTIVES: To present epidemiological data and characterize molecular subtypes of 13 strains of Sporothrix schenckii, and to correlate clinical and epidemiologic presentation with subtypes. METHODOLOGY: Thirteen Mexican cases of sporotrichosis were identified, and mitochondrial DNA (mtDNA) from clinical isolates of S. schenckii were analyzed using RFLP Hae III. Molecular types 2, 3, 14, 28, and 29 were observed. RESULTS: Clinical presentations and molecular types were consistent with established epidemiologic patterns for S. schenckii in this region. CONCLUSIONS: This investigation provides further evidence of the strong regional specificity of molecular types of this organism.     

Disseminated Sporotrichosis

The clinical manifestations of sporotrichosis can be classified into three disease patterns: (1) localized lymphatic sporotrichosis, (2) fixed cutaneous (or endemic) sporotrichosis, and (3) disseminated sporotrichosis. This presentation reflects a rare disseminated form of the disease with extensive cutaneous and systemic lesions, and further illustrates the difficulty in diagnosing systemic sporotrichosis infection.     

Fixed cutaneous sporotrichosis: Unusual histopathology following intralesional corticosteroid administration

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.     

Sporotrichosis in childhood: clinical and therapeutic experience in 25 patients

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.     

Atypical presentation of cutaneous sporotrichosis in an alcoholic patient

Sporotrichosis is a subcutaneous mycosis with a high prevalence in Brasil. It is caused by the dimorphic fungus Sporothrix schenckii, and may lead to different clinical presentations. The disseminated cutaneous form is uncommon and corresponds to 4 percent of the total number of cases. We report a case of atypical disseminated sporotrichosis in an alcoholic patient, whose culture for fungi revealed the presence of Sporothrix schenckii. The patient was treated with itraconazole 200 mg/day for 6 months with clinical clearing.     

碘化钾治疗孢子丝菌病的实验研究

对不同免疫状态小鼠造成孢子丝菌实验性感染，观察碘化钾的治疗作用和病损发展过程中病原体与炎症浸润细胞的变化及两者间的关系。结果进一步证实碘化钾对孢子丝菌病的治疗作用与宿主的免疫力有关，并发现碘化钾具有促进巨噬细胞在感染部位的浸润和增强小鼠对孢子丝菌的抵抗力，还表明碘化钾对小鼠内脏感染无效，而对血源播散型皮肤感染的作用因小鼠的免疫状态而异。     

Sporotrichosis in a husband and wife

Familial occurrence of sporotrichosis is rare. We report two patients, a husband and wife, with sporotrichosis. A 67-year-old man and a 63-year-old woman, who were farmers, had erythematous plaques and nodules on their faces and his forearm. They had noticed their cutaneous lesions during nearly the same period without any traumatic history. Fragments of biopsy specimens from both of them were submitted for mycological cultures and yielded pure cultures of Sporothrix schenckii (S. schenckii). Restriction fragment length polymorphisms in the mitochondrial DNA of the S. schenckii isolated from the biopsy specimens of their lesions were investigated. The isolates were identified as type 5, which is comparatively abundant in the Kanto area in Japan. The husband was treated with potassium iodide and itraconazole. His wife was treated with itraconazole alone. We failed to isolate a causative fungus from the soil. Our case is the second case in the literature of sporotrichosis in a husband and wife during the same period.