中华皮肤科杂志 ›› 2002, Vol. 35 ›› Issue (5): 337-339.

• 论著 • 上一篇    下一篇

白念珠菌颈淋巴结炎一例

桑红1, 倪容之1, 沈献平1, 吴波3, 伏洁2, 张新华3, 李幼生4, 周晓军3, 孙桂勤3, 郑晓刚3   

  1. 1. 南京军区南京总医院皮肤性病科, 210002;
    2. 南京军区南京总医院儿科, 210002;
    3. 南京军区南京总医院病理科, 210002;
    4. 南京军区南京总医院普外科, 210002
  • 收稿日期:2001-10-30 出版日期:2002-10-15 发布日期:2002-10-15
  • 基金资助:
    中华医学会皮肤性病科分会科研基金资助项目(200117)

Cervical Lymphadenitis Caused by Candida albicans:A Case Report

SANG Hong1, NI Rongzhi1, SHEN Xianping1, WU Bo3, FU Jie2, ZHANG Xinhua3, LI Yousheng4, ZHOU Xiaojun3, SUN Guiqin3, ZHENG Xiaogang3   

  1. Department of Dermatovenereology, Jinling Hospital, Nanjing 210002, China
  • Received:2001-10-30 Online:2002-10-15 Published:2002-10-15

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摘要： 目的 报道国内首见白念珠菌性淋巴结炎1例。方法 全面临床检查排除其他疾病;进行了淋巴结培养、鉴定、组织病理、透射电镜、流式细胞仪、细胞免疫学检测等研究。结果 患者为8岁男孩,平时体健,一次颈部皮肤轻微的外伤后,颈部淋巴结广泛肿大,手术取一淋巴结进行培养鉴定为白念珠菌生长,组织病理检查发现在淋巴结中有大量出芽孢子及假菌丝。用流式细胞仪对患者进行细胞免疫学检查,发现患者细胞免疫低下。患者接受氟康唑静脉滴注,同时用小牛胸腺肽增强患者细胞免疫、手术切除等综合治疗,并口服氟康唑及特比萘芬维持治疗2个月。患者病情明显好转,淋巴结不能触及。随访至今细胞免疫状况有明显改善,且无其他异常发现。结论 复习文献,局限性白念珠菌淋巴结炎国内未见报道,细胞免疫等综合治疗有效。

关键词: 念珠菌,白色, 淋巴结炎

Abstract: Objective To report the first case of cervical lymphadenitis caused by Candida albicans in China.Methods A series of clinical,histopathologic.and mycologic studies were carried out in an 8 year-old-boy with cervical lymphadenitis,who had no definite underlying disease.Candida albicans was isolated from the patient.The lymph node was investigated by means of culture,pathological and transmission electron microscopic examination and cellular immunology detected by flow cytometer.Results There were several enlarged,warm,and fluctuant cervical lymph nodes which varied from 1cm×1cm to 4cm×4cm in size.One swollen node was excised,and Candida albicans was found in the culture.The histopathologic changes of the cervicallym phnode were compatible with chronic granulomatous disease.PAS and methenamine silver(PAM)stain of a touch preparation of the biopsy specimen revealed budding spores and pseudohyphae.Lymphopenia with aproportionate decrease of T-helper and T-suppressor cells was shown with flowcytometry.The patient received a combination therapy of surgery,flu conazole,thymosin and so on.After one month,the patient's condition was improved.Many small lymph nodes disappeared,large lymph nodes became smaller.Two months later,only one large lymph node could be touched.Conclusion It is the first case of cervical lymphad enitis caused by Candida reported in China.Combination therapy of surgery,fluconazole and thymosin is effective.

Key words: Candida albicans, Lymphadenitis