国内首例总状共头霉所致原发性皮肤毛霉病及文献复习

目的:报道1例总状共头霉所致的原发性皮肤毛霉病并进行文献复习。方法:患者,女,67岁。反复右踝结节、渗液伴疼痛3年。取患者皮损进行真菌镜检及培养,对皮损进行组织病理检查,并对分离菌种行r DNA ITS测序鉴定。结果:显微镜下可见宽而无分隔、成直角分支的菌丝。培养见白色菌落生长,生长较快,菌落呈疏松絮状,灰褐色绒毛状,边缘呈羊毛状向外延伸。皮损组织病理示:真皮全层弥漫性炎细胞浸润,散在多核巨细胞,可见大量团块状菌丝。PAS和嗜银染色阳性。分子测序鉴定为总状共头霉。确诊后外科结合伊曲康唑等治疗取得良好效果。结论:该病例致病菌为总状共头霉,外科治疗结合伊曲康唑治疗有效。

Primary cutaneous mucormycosis caused by Syncephalastrum racemosum in China：a case report and literature review

Objective: To report a case of primary cutaneous mucormycosis caused by Syncephalastrum racemosum and review the related literature. Methods:A 67-year-old female presented with painful nodules and exudation on right ankle for 3 years. Smear and lesional tissues were taken for fungal culture and his￣topathologic examination. PCR ( rDNA ITS sequence analysis) was performed to identify the species of the cul￣tured fungi. Results: Microscopically demonstrated numerous hyphae. Numerous white cottony colonies grew on SDA culture medium. Microscopic examination of the H&E-stained tissue slides revealed a chronic granu￣lomatous inflammation. In the tissue examined, clumps hyphae of various lengths were observed. The PAS and Silver stains also showed positive hyphae. The strain was identified as Syncephalastrum racemosum by ITS se￣quence analysis. The patient was improved with surgical intervention and oral itraconazole. Conclusion: The pathogen of this case is caused by Syncephalastrum racemosum. Itraconozole and surgical intervention is effec￣tive.