中华皮肤科杂志

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冠状耳霉引起虫霉病一例

杨秀敏1, 王毓新1, 耿素英1, 李娅娣1, 周晓谦1, 刘红刚2, 杨庆文3   

  1. 1. 首都医科大学北京同仁医院皮肤性病科 北京 100730;
    2. 首都医科大学北京同仁医院病理科 北京 100730;
    3. 首都医科大学北京同仁医院耳鼻咽喉科 北京 100730
  • 收稿日期:2005-10-31 出版日期:2006-04-15 发布日期:2006-04-15

Entomophthoromycosis caused by Conidiobolus coronatus

YANG Xiu-min1, WANG Yu-xin1, GENG Su-ying1, LI Ya-di1, ZHOU Xiao-qian1, LIU Hong-gang2, YANG Qing-wen3   

  1. Department of Dermatovenereology, Affiliated Beijing Tong Ren Hospital of Medical Capital University, Beijing 100730, China
  • Received:2005-10-31 Online:2006-04-15 Published:2006-04-15

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摘要： 目的 报道1例由冠状耳霉感染引起的虫霉病.方法 病史及全面临床检查包括鼻部X线、CT、核磁共振(MRI)、鼻内镜等,排除其他肿瘤性疾病;病变部位组织活检,真菌直接镜检、培养、病理检查;临床用药治疗观察.结果 组织病理检查见嗜酸细胞性肉芽肿,多核巨细胞内可见横断的壁薄而宽的菌丝,周围有(PAS染色)嗜酸性物质包裹(splendore-Hoeppli现象).组织真菌培养可在平皿培养基背面见到与菌落形状相同的映象(弹射孢子形成的),显微镜下看到球彤孢子囊,锥状顶圆乳突,较多的小孢子囊冠及长柔毛孢子囊.经口服10%碘化钾20～30mL每日3次,联合增效联磺片1.0g每日2次,治疗半个月后,瘙痒消失,皮损缩小.证实为冠状耳霉引起的虫霉病.结论 冠状耳霉引起虫霉病为国内首报,碘化钾联合增效联磺片治疗有效.

关键词: 接合菌病, 耳霉属

Abstract: Objective To report a case of entomophthoromycosis caused by Conidiobolus coronams.Methods Other tumorous diseases were ruled out in this patient by the history and a series of clinical and laboratory evaluations of the nose,including X-ray,computed tomographic(CT),magnetic resonance imaging(MRI)and endoscopic examinations.Biopsy and fungal culture of the lesion were performed.The effect of the treatment was also evaluated.Results The histopathological examination of the specimen taken with nasal endoscope showed eosinophilic granuloma,as well as transverse hyphae(surrounded by eosinophilic material,i.e.Splendore-Hoeppli phenomena)with thin and broad wall in multinucleated giant cells.Ejected sporangioles developed satelite colonies in fungal culture of tissue,especially in potato medium,which could be seen through the cover of flat plates.Microscopic examination showed coccoid sporangia with pyramidal papilla,ascus crowns developed by numerous sporangiola,and villose sporangiolum.Resolution of the pruritus and flattening of the lesions were seen after one week of treatment with potassium iodide 10% solution(20～30 mL tid)and SMZ-SD-TMP.Conclusions This is the first report ofentomophthoromycosis caused by Conidiobolus coronatus in China.Conclusion therapy with potassium iodide and SMZ-SD-TMP is effective for this condition.

Key words: Zygomycosis, Conidiobolus