Microsphaeropsisarundinis引暗色丝孢霉病一例起  

Phaeohyphomycosis caused by Microsphaeropsis arundinis： a case report

作　　者：刘泽虎[1] 夏修蛟[1] 钟燕[1] 桑波[1] 吕闻闻[1] 王媚[1] 沈宏[1] 许爱娥[1] 

机构地区：[1]杭州市第三人民医院皮肤科,310009

出　　处：《中华皮肤科杂志》2013年第8期554-556,共3页Chinese Journal of Dermatology

基　　金：杭州市科技局重点专科专病项目（20L00733Q09）

摘　　要：患者女，68岁，左前臂红色斑块4个月，类风湿关节炎病史4年。皮肤科检查：左手背、左手腕部和左前臂5cm×10cm暗红色斑块，边界不清，可见少许脓性分泌物、紫癜。取皮损脓液10％KOH镜检，见棕黄色分隔菌丝；脓液和皮损组织沙氏葡萄糖琼脂均培养出局限性、绒状、灰黑色菌落；马铃薯葡萄糖琼脂上培养，不产孢，仅见暗色分隔菌丝。皮损组织病理检查：感染性肉芽肿，过碘酸雪夫染色见酵母细胞和出芽的假菌丝。分离菌株与Microsphaeropsisarundinis的ITS片段序列比对，结果99％符合。诊断：M．arundinis所致皮肤暗色丝孢霉病。治疗：口服伊曲康唑胶囊400mg／d结合温热疗法治疗，4个月后皮损完全消退。随访1年无复发。A 68-year-old woman presented with a four-year history of rheumatoid arthritis and a four-month history of erythematous plaque on the left forearm. Dermatological examination revealed a dark erythematous, ill- defined plaque measuring 5 cmx 10 cm over the left dorsal hand, wrist, and forearm, with purpura and a small amount of purulent discharge. Direct microscopic examination of the pus in 10% potassium hydroxide showed pale brown, branched and septate hyphae. Culture of pus and lesional tissue grew dark gray, velvety, confined colony on Sabouraud dextrose agar. Slide cultures on potato dextrose agar resulted in the formation of dark septate hyphae, but no spores were observed. Histopathological examination of the lesional tissue revealed infectious granuloma, and periodic acid-Schiff staining showed violet to red yeasts and pseudohyphae. Sequencing analysis of the internal transcribed spacer （ITS） region revealed a 99% consistence between the clinical isolate and reference strain of Microsphaeropsis arundini~ Based on the above findings, the patient was diagnosed with subcutaneous phaeohyphomycosis caused by M. arnndinis. She was given itraconazole 400 mg once daily orally as well as thermotherapy. Four months later, the lesion completely resolved. No recurrence was observed during one-year follow-up.

关 键 词：暗色丝孢霉病 腔孢菌科 Microsphaeropsis arundinis 关节炎 类风湿 

分 类 号：R7[医药卫生—临床医学]