秋葵叶茎毛刺刺伤后Fonsecaea monophora感染的着色芽生菌病1例  

Chromoblastomycosis Caused by Fonsecaea Monophora from Abelmoschus Esculentus(Okra):A Case Report

作　　者：张彩云 周玮欣 朱梓波 张伟铮 屈平华[5] 李文均[6] 谢婷[2,3] 林颖 ZHANG Caiyun;ZHOU Weixin;ZHU Zibo;ZHANG Weizheng;QU Pinghua;LI Wenjun;XIETing;LIN Ying(The Second Clinical Medical College of Guangzhou University of Traditional Chinese Medicine,Guangzhou 510006,China;Department of Dermatology,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120,China;Guangdong Provincial Research Center of Traditional Chinese Medicine Dermatology Clinical Medicine,Guangzhou 510006,China;Medical Laboratory Division,Guangzhou Eleventh People′s Hospital,Guangzhou 510530,China;Laboratory Division,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120,China;School of Life Sciences,Sun Yat-Sen University,Guangzhou 519080,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510006 [2]广东省中医院皮肤科,广东广州510120 [3]广东省中医皮肤临床医学研究中心,广东广州510006 [4]广州市第十一人民医院医学检验科,广东广州510530 [5]广东省中医院检验科,广东广州510120 [6]中山大学生命科学学院,广东广州519080

出　　处：《中国皮肤性病学杂志》2022年第12期1426-1430,1434,共6页The Chinese Journal of Dermatovenereology

基　　金：国家自然科学基金面上项目(31972856);广东省中医药防治难治性慢病重点实验室(2018B030322012);广东省中医皮肤临床医学研究中心及广东省中医皮肤病研究所专项课题(PFK2021-02);广东省中医院拔尖人才项目(BJ2022YL08)

摘　　要：患者女,66岁,因采摘秋葵时右手臂伸侧被秋葵叶片及梗茎毛刺刺伤后,出现局部红斑、丘疹,后皮损逐渐扩大,形成结节和疣状斑块,4个月后因小腿外伤就诊皮肤专科引起重视并开始诊治。皮损组织病理示:肉芽肿性炎,真皮中性粒细胞脓疡和多核巨细胞内可见多个圆形厚壁的暗棕色小体。真菌培养可见圆形棕褐色菌落,表面短绒毛状。组织NGS鉴定为单瓶着色真菌(Fonsecaea monophora),诊断着色芽生菌病。治疗以伊曲康唑200 mg, 2次/d,配合中药间断口服,用药后皮疹迅速好转,治疗9个月后皮疹完全消退,停药随访半年未见复发。A 66-year-old female presented with local erythema and papules on her right arm pricked by okra spines on leaves and stems during the harvesting. The lesions expanded gradually, then formed nodules and verrucous plaques. After 4 months, the arm lesions got the attention from a dermatologist when she went for treating a calf trauma. The histopathological biopsy from the arm revealed granulomatous inflammation, neutrophilic abscesses in dermis, and brown multiple roundish, thick-walled sclerotic bodies within multinucleated giant cells. Fungal culture of rash tissue showed round gray-brown colonies with short villous surfaces. Fonsecaea monophora was identified by tissue NGS. Diagnosis of chromoblastomycosis caused by Fonsecaea monophora was made. The rashes were alleviated rapidly after the treatment with itraconazole 200 mg twice a day, combined with intermittent oral traditional Chinese medicine, and the lesions completely subsided after 9 months of treatment.

关 键 词：着色芽生菌病 单瓶着色真菌 伊曲康唑 肾病综合征 

分 类 号：R756[医药卫生—皮肤病学与性病学]