中华皮肤科杂志 ›› 2008, Vol. 41 ›› Issue (4): 217-219.

• 论著 • 上一篇    下一篇

毛霉病七例临床与病理分析

陈佳 曾学思 姜祎群 等   

  1. 南京市中国医学科学院皮肤病研究所 南京医科院皮研所 南京医科院皮研所
  • 收稿日期:2007-06-03 修回日期:2007-11-06 发布日期:2008-04-15
  • 通讯作者: 陈佳 E-mail:chenjia.skin@yahoo.com.cn

  

  • Received:2007-06-03 Revised:2007-11-06 Published:2008-04-15

摘要: 目的 探讨毛霉病的临床表现、预后和病理表现之间可能存在的关系。方法 回顾性分析1989-2006年我院诊治的7例经真菌培养证实为毛霉病患者的临床资料和病理切片。结果 7例中鼻脑毛霉病1例、皮肤毛霉病6例,其中2例为毛霉性坏死性筋膜炎。鼻脑毛霉病和毛霉性坏死性筋膜炎患者病情进展快,均以死亡告终;其皮损组织病理表现呈混合性炎症细胞浸润,坏死明显,可见大量菌丝和侵血管现象。4例以浸润性红斑为主要表现的皮肤毛霉病患者病情进展慢,有2例已治愈;其皮损组织病理呈肉芽肿性炎症,菌丝较少,未见明显的侵血管现象。7例均未见明确的菌丝侵神经现象。结论 毛霉病皮损组织病理表现呈混合性炎症细胞浸润,菌丝多,出现明显侵血管现象者预后较差。

Abstract: Objective To investigate the relationship between the clinical manifestations, prognosis and histopathological findings of mucormycosis. Methods The clinical data on and pathological findings from 7 cases of mucormycosis confirmed by fungal culture in the institute from 1989 to 2006 were analyzed retrospectively. Results There was 1 case of rhinocerebral mucormycosis and 6 cases of cutaneous mucormycosis, among them, 2 were mucormycotic necrotizing fasciitis(MNF). The condition of patients with rhinocerebral mucormycosis or MNF aggravated rapidly and all the 3 patients died from mucormycosis. Histopathological examination showed mixed infiltrates of inflammatory cells as well as necrosis and angioinvasion. On the contrary, the condition of the remaining 4 patients with cutanesus mucormycosis, who presented mainly with indurated erythematous patch, progressed slowly, and 2 patients were cured. Histologically, the lesions were characterized by granulomatous infiltration with a few hyphae; no typical angioinvasion phenomenon was noted. There was no evidence of perineural invasion with hyphae in any of the 7 cases. Conclusion In patients with mucormycosis, histopathological findings characterized by mixed infiltrates of inflammatory cells, numerous hyphae and typical angioinvasion phenomenon may herald a poor prognosis.