CAJ | 학술논문

患儿女,5岁,内蒙古人.左面颊皮疹10个月.起病前数周局部曾被犬抓伤,初起为无症状小红丘疹,渐扩大.皮屑镜检见分支分隔菌丝,皮屑培养示阿姆斯特丹散囊菌(曲霉有性期),初诊为皮肤曲霉感染.给予伊曲康唑200 mg/d治疗2个月,疗效欠佳.组织病理检查及瑞氏-吉姆萨染色,见真皮及皮下组织细胞内外大量利-杜小体,PAS染色未见真菌成分,组织真菌培养阴性,确诊为皮肤利什曼病.给予特比萘芬125 mg/d治疗2个月后皮疹痊愈.
환인녀,5세,내몽고인.좌면협피진10개월.기병전수주국부증피견조상,초기위무증상소홍구진,점확대.피설경검견분지분격균사,피설배양시아모사특단산낭균(곡매유성기),초진위피부곡매감염.급여이곡강서200 mg/d치료2개월,료효흠가.조직병리검사급서씨-길모살염색,견진피급피하조직세포내외대량리-두소체,PAS염색미견진균성분,조직진균배양음성,학진위피부리십만병.급여특비내분125 mg/d치료2개월후피진전유.
A 5-year-old Mongolian girl from Inner Mongolia presented with a painless,round skin lesion on the left cheek for 10 months.Several weeks prior to the development of lesions,her left cheek was seratched by a dog.Subsequently small asymptomatic erythematous papules developed at the scratched site and gradually enlarged.Direct microscopy of scales from the lesions revealed septate,branching hyphae and fungal culture grew Eurotiom amstelodami (perfect stage of aspergillus).She was initially diagnosed as cutaneous aspergillosis and treated with itraconazole 200 mg per day for 2 months,but limited improvement was achieved.Histopathological examination with Wright-Giemsa staining of skin biopsies revealed abundant leishman Donovani hodies intracellulatry and extracellularly in the dermis and subcutaneous tissue; PAS staining of tissue specimens showed no fungal element and fungal culture was negative.She was finally diagnosed with cutaneous leishmaniasis.After treatment with terbinafine 125 mg per day for 2 months,the lesion subsided.