Busse-Buschke型念珠菌性肉芽肿伴肺部感染一例  

A case of cutaneous Busse-Buschke granuloma with lung infection caused by Candida albicans

作　　者：郑岳臣[1] 刘志香[1] 冯爱平[1] 涂亚庭[1] 刘厚君[1] 黄长征[1] 毛叶红[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院皮肤性病科,武汉430022

出　　处：《国际皮肤性病学杂志》2009年第3期137-139,共3页International Journal of Dermatology and Venereology

摘　　要：患儿男，14个月。因左侧颞、颈、胸部相继发生红斑片、丘疹、结节、脓肿、溃疡伴反复发热、咳嗽9个月，门诊疑诊皮肤结核、深脓疱疮、孢子丝菌病收住院。左上胸皮损组织病理检查，显示为炎性肉芽肿，PAS染片内有大量孢子和菌丝。左颈坏死组织压片PAS染色镜检，发现大量菌丝，真菌培养及鉴定均为白念珠菌。超敏C反应蛋白（14．4mg／L）显著高于正常。总T细胞比例40．21％，CD3／CD4（26．41％）下降；抗获得性免疫缺陷病毒抗体阴性。胸部X线片及CT检查均显示双肺感染。先后给予氟康唑和伊曲康唑抗真菌治疗，经抗生素、免疫调节剂和支持治疗3个月皮损痊愈，伊曲康唑维持治疗8个月肺部炎症减轻。A fourteen-month-old boy presented with a 9-month history of erythema, papules, nodules, abscesses and ulcers on left temple, neck and chest accompanied by fever and cough. He was hospitalized for suspected tuberculosis cutis, ecthyma and sporotriehosis. Histopathology of nodules on the top of left chest showed a change characteristic of inflammatory granuloma with the presence of numerous fungal spores and hyphae. Under a microscope, a large number of hyphae were also observed in necrotic tissue specimen fi＇om the left neck with PAS staining. Fungal strains were isolated from both Aesions and identified as Candida albicans. Laboratory examination revealed an increase in the serum level of hypersensitivity C reactive protein （14.4 mg/L） along with a decrease in total T cell proportion （40.21%） and the ratio of helper T cells to inducer T cells （26.41%）. Anti-human immunodeficiency virus antibody was negative in this patient. Chest X-ray and computerized tomographic scanning （CT） showed an infection in bilateral lower lungs. After 3-month combined therapy with fluconazole, itraconazole, antibiotics, immunomodulators and supportive treatment, skin lesions were improved, and the lung infection was controlled after 8-month maintenance therapy with itraconazole.

关 键 词：念珠菌病 肉芽肿 肺炎 

分 类 号：R756[医药卫生—皮肤病学与性病学]