中华皮肤科杂志

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厚壁孢子根毛霉引起深部真菌病一例

曹育春1, 陈兴平1, 曾学思2, 陈辉2, 万沐芬1, 李守新1   

  1. 1. 华中科技大学同济医学院附属同济医院皮肤科, 武汉430030;
    2. 中国医学科学院皮肤病研究所
  • 收稿日期:2007-01-04 出版日期:2007-11-15 发布日期:2007-11-15
  • 作者简介:曹育春(email:caoyuchun@tjh.tjmu.edu.cn)

A case of deep mycosis caused by Rhizomucor chlamydosporus

CAO Yu-chun1, CHEN Xing-ping1, ZENG Xue-si2, CHEN Hui2, WAN Mu-fen1, LI Shou-xin1   

  1. Department of Dermatology, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
  • Received:2007-01-04 Online:2007-11-15 Published:2007-11-15

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摘要： 目的 报道厚壁孢子根毛霉引起深部真菌病1例.方法 了解患者的病情经过,病理检查及相关实验室检查,并作病变组织真菌镜检、培养与鉴定.结果 患者男,41岁.临床表现为右臀部、两侧腹股沟及胰头后方先后出现肿块,伴轻度疼痛,进行性加重.后期皮肤肿块处出现溃疡、坏死、黑痂,伴恶心、呕吐、肝功能异常.病理表现为真皮及皮下组织慢性肉芽肿改变,于血管内或多核巨细胞内、或组织间见分支不分隔或少数分隔的粗大菌丝,并可见少数厚壁孢子及分隔菌丝,PAS染色阳性.真菌鉴定为厚壁孢子根毛霉(Rhizomucor chlamydosporus).结论 该病例初表现为侵袭性肉芽肿,后出现坏死性溃疡,进展较快,最后导致恶液质而死亡.

关键词: 根毛霉菌属, 真菌病

Abstract: Objective To report a case of deep mycosis caused by Rhizomucor chlamydosporus. Methods Medical history,histopathology and laboratory examination were investigated,and fungal identification by microscopy and culture as well in the patient.Results The patient,a 41-year-old male,initially presented with mild-tender and progressively aggravating masses on the right glutea,both groins,and back of the head of pancreas.Later,ulcer,necrosis,and black crusts developed at the primary lesions accompanied with nausea,vomitting and dysfunction of liver.Pathological examination revealed a chronic granulomatous inflammation in the dermis and subcutaneous tissue;and branching,nonseptate and broad hyphae in multinuclear giant cells,tissue spaces and blood vessel lumens,and,few PAS-positive septate hyphae as well as basophilic chlamydospores located in multinuclear giant cells.The isolate was identified as R. chlamydosporus.Conclusions The case of deep mycosis caused by R.chlamydosporus began with invasive granuloma,followed by necrotic ulcer,with condition aggravating rapidly,and the patient finally died of serious cachexia.

Key words: Rhizomucor, Mycoses