足部皮肤镰刀菌病  

Foot ulcer caused by Fusarium solani:a case report

作　　者：林映萍[1] 杨艳平[1] 黄文明[1] 李文[1] 樊翌明[1] 

机构地区：[1]广东医学院附属医院皮肤性病科,广东湛江524001

出　　处：《临床皮肤科杂志》2011年第1期3-5,共3页Journal of Clinical Dermatology

摘　　要：目的:报告1例由茄病镰刀菌引起的足部皮肤镰刀菌病。方法:皮损分泌物直接镜检、真菌培养,活检皮损作组织病理学检查,培养、分离菌株行DNA序列分析和体外药敏试验。结果:皮损直接镜检见无色、分隔菌丝,组织病理显示真皮内菌丝和孢子。沙堡弱培养基(SDA)和马铃薯葡萄糖琼脂培养基(PDA)培养出灰白色棉絮状菌落,微量培养可见大、小分生孢子和厚壁孢子,具有镰刀菌样细胞结构特征。rDNA内转录间隔区(internal transcribed spacer,ITS)序列分析符合茄病镰刀菌。对两性霉素B、制霉菌素、特比萘芬敏感。给予口服特比萘芬0.25 g,每天2次,治疗5个月后皮损完全愈合。结论:该例为由茄病镰刀菌感染引起的足部溃疡,特比萘芬治疗有效。Objective： A case of foot ulceration caused by Fusarium solani is reported. Methods：Discharge from the ulcer was taken for microscopic examination and fungal culture, and the skin specimens were taken for fungal culture and histopathological examina- tion. The antifungal susceptibility of the isolated strain was tested in vitro and the DNA sequencing conducted with rDNA ITS（internal transcribed spacer）. Results： Septate, hyaline hypha was observed by direct microscopy and the spores and hypha embedded in the dermis of skin specimens were shown by histopathology. A grayish-white, cotton-fluff-like coenobium, colony was seen on the Sabouraud dextrose agar （SDA） and potato dextrose agar （PDA）. The microconidium, macroconidium and chlamydospore were consistent with those of Fusarium solani, shown as microcuhure. The isolated strain was identified as fusarium solani by ITS analysis. And, it was highly susceptible to terbinafine, nystatin and amphotericin B. The lesion was completely healed after 5 months of treatment with terbinafine（0.25 g twice daily）. Conclusion： This case is diagnosed foot ulceration due to Fusarium solani infection and terbinafine treatment is effective.

关 键 词：足部溃疡 镰刀菌 rDNA内转录间隔区 DNA序列分析 

分 类 号：R756.6[医药卫生—皮肤病学与性病学]