急性早幼粒细胞白血病患者小孢根霉变种感染1例  

A case report of cutaneous infection by Rhizopus microsporus variants with acute promyelocytic leukemia

作　　者：王露霞[1] 赖晃文[2] 石凌波[3] 梁宇恒[4] 李利[5] 吴小丽[2] 付捷 刘海英 

机构地区：[1]广州军区广州总医院检验科,广州510010 [2]广州军区广州总医院医学实验科,广州510010 [3]广州中医药大学祈福医院检验科,广州511495 [4]广州中山大学孙逸仙医院皮肤科,广州510120 [5]广州军区广州总医院血液科,广州510010 [6]广州市妇女儿童医疗中心检验科,广州510180

出　　处：《中国真菌学杂志》2012年第1期33-36,共4页Chinese Journal of Mycology

摘　　要：报道1例由小孢根霉变种导致的皮肤毛霉病。患者女,30岁。因患急性早幼粒细胞白血病,化疗后继发口腔颌面部小孢根霉变种感染,表现为发热、右侧颊黏膜水肿,皮损中央溃疡、焦痂,周边组织炎性水肿,以面颊部、颌下区为中心明显肿胀,逐渐累及右侧颈部及右下颌,进行性加重。坏死组织涂片镜检显示有粗大、无分隔直角菌丝,真菌学检查鉴定为小孢根霉,分子测序证实为小孢根霉变种。给予两性霉素B、伊曲康唑静脉滴注和手术清创,坏死组织连续3次真菌培养均未培养出小孢根霉变种,患者体温逐渐恢复正常,治疗2周后颔面部肿胀明显减退,浅表淋巴结未触及肿大,4周后额部及右眼睑肿胀已完全消退,伤口结痂愈合。随访2 a,右侧颌下可见长约2 cm手术疤痕,未见皮肤毛霉病复发。A case of cutaneous mucormycosis caused by Rhizopus microsporus variants was reported.An 30-year-old female with immunodeficiency and granulocytopenia after chemotherapy for acute promyelocytic leukemia was sufferred form fever and mucosa edema in the right submaxillary area,which gradually involved the right neck and right mandible.Necrotic tissue smear showed thick and right angle hyphae,which was further identified as Rhizopus microsporus variants by mycological examination and DNA sequencing.After intravenous amphothericin B and itraconazole with surgical debridement,the body temperature returned to normal.The lesion improved after two weeks and healed after four weeks without relapse within two years.

关 键 词：急性早幼粒细胞白血病 小孢根霉变种 毛霉病 皮肤 

分 类 号：R756.6[医药卫生—皮肤病学与性病学]