卡氏枝孢霉致着色芽生菌病1例

着色芽生菌病(chromomycosis)是由一组暗色真菌引起的皮肤及皮下组织慢性肉芽肿性疾病,病程慢性,皮损一般局限,也有逐步扩展的,少数可经血液播散,侵入内脏器官,危及生命.现将我科诊断的1例由卡氏枝孢霉引起的着色芽生菌病报告如下.     

伊曲康唑治疗着色芽生菌病后出现暂时性增生性皮疹一例

患者,男,67岁。鼻部增生性斑块4个月,有外伤史。实验室检查：组织病理可见真菌孢子,真菌镜检可见硬壳小体,真菌培养与菌种鉴定为卡氏枝孢瓶霉。予伊曲康唑、热敷治疗,患者治疗第1个月后原皮损部位出现的增生性皮疹,继续原治疗方案3个月,增生性皮疹萎缩,基本痊愈。出现增生性皮疹的原因猜测为伊曲康唑治疗后,皮损部位的真菌细胞膜功能受损,大量异种蛋白被机体识别,加重了局部的炎症反应,具体原因还需要进一步研究。     

伊曲康唑加局部温热疗法治疗着色芽生菌病

目的　观察伊曲康唑加局部温热疗法治疗着色芽生菌病的疗效和安全性。方法　 12例给伊曲康唑 2 0 0mg 2次 /d ,连续 7天后改变为 10 0mg 2次 /d ;同时局部热疗 ,40℃～ 60℃。 结果　 11例培养阳性的患者的病原菌均为卡氏枝孢霉。 12例患者全部治愈。疗程 1.5～ 5 .5月 ,平均 (3 .1± 1.2 )月 ,伊曲康唑用量为 10 .5～ 3 5 .0 g ,平均 (19.8± 7.2 )g。病程小于 3年的患者疗程短于病程长于 3年者。结论　伊曲康唑加局部温热疗法治疗卡氏枝孢霉引起的着色芽生菌病疗效好、副作用小 ,病程长的患者所需疗程较长     

裴氏着色霉致着色芽生菌病一例

患者,男,62岁.左下肢红斑结节10年余,逐渐加重1年.皮肤组织病理示真皮内可见散在棕色孢子样结构.PAS染色示真皮内见圆形、厚壁硬壳小体.真菌培养示着色霉属;菌落基因测序鉴定为裴氏着色霉.     

裴氏着色芽生菌病1例

患者女，40岁，10年前无明显诱因，左踝部出现米粒大红色结节，渐增大，增多，自学轻微痛痒，部分皮损表面破溃，有分泌物及黄色痂皮。曾外用糖皮质激素，抗真菌药及口服抗结核药物治疗，均无效。于2003年12月11日来我院就诊，体格检查：一般情况可，左侧小腿远端近踝部可见绿豆至黄豆大结节及斑块，结节质地硬，表面结灰黄色痂皮，挤压后可见脓性分泌物渗出，部分皮损融合。     

裴氏着色霉所致皮肤着色芽生菌病1例

报道1例前臂着色芽生菌病。患者女，46岁。左前臂斑块结节10余年，抗感染治疗无效，皮肤组织病理和真菌培养均符合着色芽生菌病。     

皮肤着色芽生菌病1例

1临床资料 患者男,35岁,农民,主因右下肢皮肤疣状结节斑块破溃、渗出,反复发作进行性加重13年,于2003年4月26日收住院.患者入院前13年,小腿内侧外伤后出现散在黄豆及蚕豆大小暗红色疣状结节,逐渐增大形成斑块,表面破溃,有脓性分泌物.     

着色芽生菌病一例

患者男,46岁,某宾馆垃圾清运员.因右膝关节下方皮损1年余,进行性增大于2008年2月17日来我科就诊.1年前右膝关节下方内侧区不明原因出现一元钱硬币大小斑块,上覆黄色厚痂,无自觉症状,自行用刀片削除.     

左下肢沿淋巴管扩散的着色芽生菌病1例

着色芽生菌病是由暗色孢科中的一组致病性着色真菌感染所引起的一种皮肤和皮下组织的深部真菌病。病程慢性,以在皮肤上形成肉芽肿性疣状增殖、结节、斑块为特征。最常见累及部位为四肢,多数患者的病灶为单侧性,可沿淋巴管扩散或自身接种。沿淋巴管扩散的着色芽生菌病临床上较少见,现报告1例。     

伊曲康唑联合局部热疗治疗着色芽生菌病1例

皮肤着色芽生菌病是由暗色孢科真菌引起的一种深部真菌病.我院于2008年2月收治1例由卡氏枝孢霉引起的着色芽生菌病患者,现报告如下. 患者男,45岁.右手背有一淡红色隆起性斑块1.5年,于2008年2月19日来我院就诊.1.5年前患者右手背无明显原因出现一绿豆大丘疹,并不断扩大,时有破溃、渗出、结痂.     

Chromoblastomycosis: report of two cases from Nepal

Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissue caused by dematiaceous fungi. The first case, a 67-year-old male farmer, presented with itchy hyperkeratotic, scaly plaques with scarring and black dots on the lateral aspects of his left arm and dorsum of his left hand of 28 years duration. The case was clinically diagnosed as chromoblastomycosis. The second case, a 75-year-old farmer, presented with erythematous, crusted, scaly plaques on the dorsum of the left foot of 30 years duration. Initially, a clinical diagnosis of lupus vulgaris was made, but treatment with anti tuberculosis therapy showed no improvement. On the basis of histopathological examinations of skin biopsies and isolation of fungus on culture, both cases were diagnosed as chromoblastomycosis. To the best of our knowledge, these two cases are the first case reports of chromoblastomycosis from Nepal and are presented for their academic interest.     

着色芽生菌病的治疗进展

着色芽生菌病是暗色真菌引起的感染性疾病中最为常见的一种。患者多是通过外伤将病原菌接种于机体而导致皮肤及皮下感染。该病治疗困难且易复发,至今仍无治疗的金标准。目前多采用手术疗法、物理疗法(CO_2激光、冷冻治疗)、化学疗法及联合疗法等,光动力、免疫调节剂等新的治疗手段和方法也应用于临床。本文就目前该病的治疗进展进行综述。     

Case of chromoblastomycosis with pulmonary involvement

Chromoblastomycosis is a slowly growing chronic cutaneous mycosis associated with a variety of cutaneous lesions. Extra‐dermal involvement is rare. A 58‐year‐old man was admitted to the hospital with nausea, vomiting, weakness and a history of weight loss. On inspection, he had a large verrucous mass in the sacral region, and two large subcutaneous nodules in the anterior thoracic wall. He claimed the lesions were several years old. Biopsy and histological studies were positive for chromoblastomycosis. Routine chest radiography showed hilar enlargement, and a chest computed tomography was ordered. Pulmonary nodules were evident, and endoscopically acquired samples were also positive for chromoblastomycosis. Extra‐dermal and systemic involvement in chromoblastomycosis is exceedingly rare and often associated with immunosuppression. There is only one other case of pulmonary chromoblastomycosis reported in the published work.     

Successful sequential treatment with itraconazole and ALA‐PDT for chromoblastomycosis because of Alternaria alternata

Alternaria alternata is a rare etiology of phaeohyphomycosis in immunocompromised patients, which has never been reported to cause chromoblastomycosis. As far as we know, this is the first chromoblastomycosis case successfully treated with a short course of systemic antifungals and subsequent 5‐aminolevulinic acid‐photodynamic therapy.     

Subcutaneous mycoses: chromoblastomycosis,sporotrichosis and mycetoma

Subcutaneous mycoses are common in subtropical and tropical regions of the world. They are rarely observed in Europe. These mycoses are heterogeneous, but all are caused by penetrating trauma of the skin. Most cases in Europe are observed in returning travelers, aid workers, archaeologists and immigrants. Therefore, a careful, thorough history is essential in order to reach a proper diagnosis. We provide up‐to‐date epidemiological, clinical, diagnostic, and therapeutic data on the three most important imported subcutaneous mycoses in Europe: chromoblastomycosis, sporotrichosis and mycetoma.     

A case of chromoblastomycosis with an unusual clinical manifestation caused by Phialophora verrucosa on an unexposed area: treatment with a combination of amphotericin B and 5-flucytosine

Chromoblastomycosis is a cutaneous and subcutaneous mycotic disease caused by the dematiaceous (black) fungi. Five species of fungi are known generally to be the cause: Fonsecaea pedrosoi, Phialophora verrucosa, Cladosporium carrionii, F. compacta and Rhinocladiella cerphilum. In infected tissue they can appear as pigmented sclerotic bodies, commonly called 'copper pennies', which are pathognomonic of chromoblastomycosis. The infection usually occurs through traumatic skin inoculation, with the majority of lesions occurring on the feet and legs of outdoor workers. We report a patient in whom the lesions had begun on the right breast, which is an unexposed area, without a history of trauma. A uniform, reliable treatment does not exist but our patient was mycologically cured with the use of amphotericin B and the subsequent combination of 5-flucytosine and itraconazole.     

卡氏枝孢霉与阿耶罗枝孢瓶霉的随机扩增DNA多态性研究

研究卡氏枝孢霉与阿耶罗枝孢瓶霉的ＤＮＡ多态性，了解两菌在ＤＮＡ型别与形态学及菌种来源地域的相互关系。采用溴苯提取法提取ＤＮＡ，以随机扩增ＤＮＡ多态性方法对来自五个国家的２１株分离株（１９株卡氏枝孢霉，２株阿耶罗枝孢瓶霉）进行研究。结果：①１０个随机引物筛选出３个具有较好ＤＮＡ扩增的引物。②１９株卡氏枝孢霉的ＤＮＡ带型具有较大的遗传相似性，阿耶罗枝孢瓶霉的ＤＮＡ带型与卡氏枝孢霉略有不同，但与中国株具有较大相似性（８５％的遗传相似性）。③卡氏枝孢霉的遗传相似性与菌株的来源地域关系密切，同一国家的菌株具有相似的ＤＮＡ带型，位于树状图的同一树组中。结论：随机扩增ＤＮＡ多态性研究发现卡氏枝孢霉具有一定的种内差异，其ＤＮＡ带型与菌株的来源地域关系密切，阿耶罗枝孢瓶霉的ＤＮＡ带型与某些株卡氏枝孢霉更相似。本研究方法简便、快速，可用于流行病学及基因学特征的研究