组织荚膜胞浆菌感染的诊断与分析(附1例报告)  

Diagnosis and analysis of Histoplasma capsulatum infection(with a case report)

作　　者：邝玉[1] 李婉宜[1] 杨远[1] 马巨辉[1] 蒋忠华[1] 李明远[1] 

机构地区：[1]四川大学华西基础医学与法医学院微生物学教研室,四川成都610041

出　　处：《中国病原生物学杂志》2009年第1期8-10,F0003,共4页Journal of Pathogen Biology

摘　　要：目的对1例组织荚膜胞浆菌病(histoplasmosis)进行病原学诊断并分析组织荚膜胞浆菌的培养特征。方法取外周血液推片,瑞氏染色,进行初步诊断;将0.1 ml血样接种于5%兔血心脑浸液琼脂平板,37℃培养分离病原菌,再将分离出的单菌落涂片染色并做单菌落小培养(25℃湿盒培养),同时转种于沙保弱培养基平板,分别置于37℃和25℃湿盒培养至4周。将25℃沙保弱培养基平板的培养物挑丝状物转种沙保弱培养基平板,置37℃培养7 d,涂片染色观察。结果血涂片瑞氏染色可见单核细胞胞浆内有多个酵母样菌,菌周有未着色的空晕;血标本接种于兔血琼脂平板37℃培养24 h后形成乳白色酵母型菌落,菌周无溶血环,单菌落25℃培养3 d镜检有典型的菌丝;用沙保弱培养基25℃培养4周后出现明显的深入培养基的丝状物,将丝状物转种后置37℃培养,孢子转变成酵母样菌。结论该菌在25℃培养形成丝状型菌落,37℃培养为酵母型菌落,符合组织荚膜胞浆菌一般特征。病例被诊断为组织荚膜胞浆菌感染。Objective To diagnose the clinic case of histoplasmosis and investigate the biological characteristics of this isolated strain from the clinic samples. Methods Peripheral blood smear stained by Wright＇s staining was adopted for primary diagnosis; inoculated 0. I ml peripheral blood sample onto brain-heart infusion （BHI） agar plate with 5 % rabbit blood, incubated the plate at 37 ℃ for isolating pathogens. Then chose mono colonies from the BHI agar plate to smear and slain and perform miniculture at 25 ℃, at the same time inoculated this mono colonies onto two Sabouraud＇s agar plate, and incubated at 37 ℃ and 25 ℃, respectively for 4 weeks. The mold obtained from Sabouraud＇s agar plate at 25 ℃ was chosen to inoculate onto another Sabouraud＇s agar plate and incubate at 37 ℃ till 7 days, being observed by smear and staining. Results Yeasts in monocyte with unstained capsule was found on the Wright＇s stained blood smear. After cultivation for 24 h at 37 ℃, there had ivory white colony without zone of hemolysis on the rabbit blood BHI agar plate that inoculated witb blood sample. The typical hyphae could be found on the minioculture after 3 days under microscopic. Hyphae extending into the Sabouraud＇s agar could be easily seen after cultured at 25 ℃ for 4 weeks, and the sub cultivation of the hyphae on Sabouraud＇s agar at 37 ℃ indicate the mold transformed into yeast. Conclusion This pathogen is mold when cultured at 25 ℃, and yeast when cultured at 37 ℃. The results accord with the biological characteristics of Histoplasma capusulatum. This case is diagnosed as histoplasmosis.

关 键 词：组织荚膜胞浆菌 外周血 培养 

分 类 号：R379.9[医药卫生—病原生物学]