中华皮肤科杂志

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由胶孢镰刀菌所致足部皮肤无色丝孢霉病一例

陈秋霞1, 黄文明1, 史建强1, 李文1, 李顺凡1, 卢荣熙1, 白逢彦2   

  1. 1. 广东医学院附属医院皮肤科 湛江 524001 ;
    2. 中国科学院微生物研究所
  • 收稿日期:2006-10-09 出版日期:2007-08-15 发布日期:2007-08-15

Foot hyalohyphomycosis caused by Fusarium subglutinans:a case report

CHEN Qiu-xia1, HUANG Wen-ming1, SHI Jian-qiang1, LI Wen1, LI Shun-fan1, LU Rong-xi1, BAI Feng-yan2   

  1. Department of Dermatology, Guangdong Medical College, Zhanjiang 524001, Guangdong, China
  • Received:2006-10-09 Online:2007-08-15 Published:2007-08-15

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摘要： 目的 报道1例南胶孢镰刀菌所致足部无色丝孢霉病。方法 询问病史及体检,取右足内踝处皮损常规病理检查:取皮损分泌物行10%KOH真菌直接镜检和培养,鉴定菌种。结果 患者女,72岁,右足溃疡3年。检查见有足踝内侧皮肤约3cm×1.5cm溃疡,基底暗红色肉芽组织增生,表面湿润,触痛明显。溃疡皮损组织病理检查,真皮浅层肉芽组织坏死,有细长、分隔、无色菌丝样结构物,其周围组织伴有慢性炎症细胞散在浸润,PAS染色显示腊肠样菌丝及散在卯圆形真菌孢子。皮损分泌物真菌镜检见分隔、分支无色菌丝。分离菌株经培养及鉴定为胶孢镰刀菌。本菌株对特比萘芬、制霉菌素及两性霉素B高度敏感。给予口服特比萘芬0.25g,每日2次,2个月后病灶完全愈合。结论 本病例为胶孢镰刀菌所致足部皮肤无色丝孢霉病,特比萘芬治疗有效。

关键词: 镰刀菌属, 真菌病, 无色丝孢霉病, 特比萘芬

Abstract: Objective To report a case of foot hyalohyphomycosis due to Fusarium subglutinans. Methods Medical history was collected and physical examination performed for this patient.Biopsy samples were obtained from the inner side of right ankle of this patient and subjected to pathological examination. Discharge was collected from the lesions for direct microscopic examination and culture.Results A 72-year-old woman presented with an ulcer on the right foot for 3 years.Physical examination disclosed an ulcer,measuring 3 cm×1.5 cm,with a moist surface and obvious tenderness,at the inner side of the right ankle.Proliferation of dusky-red granulomatous tissue was observed at the base of the ulcer.Pathological examination revealed necrotic granulomatous tissue and slender,septate and hyaline hypha-like structure in the superficial dermis with scattered infiltration of inflammatory cells.PAS staining showed sausage-like hypha and scattered orbicular-ovate spores.Microscopic examination of lesional discharge exhibited septate, branching and hyaline hypha.The isolated fungus was identified as Fusarium subglutinans by culture,and appeared to be highly sensitive to terbinafine,nystatin and amphotericin B.The lesion completely healed after 2 months of treatment with oral terbinafine (0.25 g,twice a day).Conclusions This is a case of foot hyalohyphomycosis due to Fusarium subglutinans,and terbinafine is effective for this condition.

Key words: Fusarium, Mycoses, Hyalohyphomycosis, Terbinafine