国际皮肤性病学杂志
國際皮膚性病學雜誌
국제피부성병학잡지
INTERNATIONAL JOURNAL OF DERMATOLOGY AND VENEREOLOGY
2010年
3期
131-133
,共3页
胡志敏%陈柳青%王玮臻%周小勇%童中胜%江萍%段逸群
鬍誌敏%陳柳青%王瑋臻%週小勇%童中勝%江萍%段逸群
호지민%진류청%왕위진%주소용%동중성%강평%단일군
拟青霉%透明丝孢霉病%特比萘芬
擬青黴%透明絲孢黴病%特比萘芬
의청매%투명사포매병%특비내분
Paecilomyces%Hyalohyphomycosis%Terbinafine
患者男,53岁,由于外伤引起左前臂起红斑脓疱,并缓慢扩大.刮取脓疱直接镜检见大量酵母样孢子.多次培养见淡紫色羊毛状菌落生长,小培养显微镜下见直立的分生孢子梗、顶端单轮生帚状支及大量柱状或分散柱状排列的椭圆形、近球形小分生孢子.组织病理:PAS染色可见真皮中层大量小型酵母样孢子.鉴定为淡紫拟青霉.体外药敏试验示其对特比萘芬敏感,对伊曲康唑、氟康唑及两性霉素B耐药.由淡紫拟青霉引起的皮肤透明丝孢霉病采用特比萘芬口服及外用治疗,临床疗效明显.
患者男,53歲,由于外傷引起左前臂起紅斑膿皰,併緩慢擴大.颳取膿皰直接鏡檢見大量酵母樣孢子.多次培養見淡紫色羊毛狀菌落生長,小培養顯微鏡下見直立的分生孢子梗、頂耑單輪生帚狀支及大量柱狀或分散柱狀排列的橢圓形、近毬形小分生孢子.組織病理:PAS染色可見真皮中層大量小型酵母樣孢子.鑒定為淡紫擬青黴.體外藥敏試驗示其對特比萘芬敏感,對伊麯康唑、氟康唑及兩性黴素B耐藥.由淡紫擬青黴引起的皮膚透明絲孢黴病採用特比萘芬口服及外用治療,臨床療效明顯.
환자남,53세,유우외상인기좌전비기홍반농포,병완만확대.괄취농포직접경검견대량효모양포자.다차배양견담자색양모상균락생장,소배양현미경하견직립적분생포자경、정단단륜생추상지급대량주상혹분산주상배렬적타원형、근구형소분생포자.조직병리:PAS염색가견진피중층대량소형효모양포자.감정위담자의청매.체외약민시험시기대특비내분민감,대이곡강서、불강서급량성매소B내약.유담자의청매인기적피부투명사포매병채용특비내분구복급외용치료,림상료효명현.
Cutaneous infection with Paecilomyces lilacinus is encountered worldwide, with most infections occurring either iatrogenically or in immunocompromised hosts. A case of cutaneous hyalohyphomycosis caused by P.lilacinus is reported in an immunocompetent individual. A 53-year-old-man presented with a 9-month history of a slowly enlarging erythematous and pustular lesion on the left forearm.Large quantity of yeast-like spores were noted on microscopic examination of pus from the lesion. Growth of the isolate on Sabouraud dextrose agar produced a slightly grayish lavender wooly colony. The microscopy following microculture of the isolate revealed erect conidiophores, single-whorl penicilli, and numerous ellipse or subsphaeroidal microconidiae arranged in prismatic or dispersed prismatic shape, which was characteristic of P.lilacinus. Histopathology and PAS staining showed lots of small yeast-like spores in mid dermis. The isolate,which was finally identified as P.lilacinus, showed sensitivity to terbinafine in vitro, but resistance to itraconazole, fluconazole and amphotericin B. Oml and topical terbinafine is effective for the treatment of cutaneous hyalohyphomycosis caused by P. lilacinus.