皮肤播散型孢子丝菌病1例并文献复习  

Cutaneous disseminated sporotrichosis:a case report and literature review

作　　者：刘雯[1] 邵丽芳[1] 赵庆利[1] 赵广[1] LIU Wen;SHAO Li-fang;ZHAO Qing-li;ZHAO Guang(Department of dermatology,Air Force General Hospital,Beijing 100142)

机构地区：[1]空军总医院皮肤科,北京100142

出　　处：《中国真菌学杂志》2018年第1期30-33,共4页Chinese Journal of Mycology

摘　　要：目的探讨皮肤播散型孢子丝菌病发生的病因、临床特点、诊断及鉴别诊断,以提高对该病的认识,避免误诊、误治。方法对1例以声嘶为首发表现的皮肤播散型孢子丝菌病的临床资料、组织病理、真菌培养结果进行分析,并进行相关文献复习。结果患者以声嘶为首发表现,3个月后出现全身散在皮下结节。结节逐渐增多,部分破溃伴脓血。咽部组织病理示鳞状上皮黏膜急慢性炎伴上皮乳头状增生,可见多核巨细胞,抗酸染色未查出阳性菌。皮损处脓液真菌镜检及培养阴性。病理符合感染性肉芽肿。组织真菌培养见孢子丝菌生长。诊断为皮肤播散型孢子丝菌病。结论皮肤播散型孢子丝菌病在免疫正常人群发病时容易导致误诊误治;皮损表面脓液真菌镜检及培养阳性率低。病变组织真菌培养有利于得到阳性结果,早日明确诊断和治疗。Objective Investigate the etiology,clinical characteristics,diagnosis and differential diagnosis of cutaneous disseminated sporotrichosis to improve the understanding of the disease and to avoid misdiagnosis and mistreatment.Methods The clinical symptoms,histopathology,and fungal culture results of a patient with cutaneous disseminated sporotrichosis were analyzed and literatures were reviewed.Results The patient suffered hoarseness at the very beginning.Three months later several nodules were distributed on her body.Nodules gradually increased and ulcerated with pus and blood.Histopathological examination of pharyngeal portion showed papillomatosis and multinucleated giant cells.But acid-fast stain test was negative.Fungal examination with microscope and culture from the pus of lesions were negative.Histopathological examination of skin lesions showed infective granulomas.Fungal culture of tissue was positive.Cutaneous disseminated sporotrichosis was confirmed.Conclusion In immunocompetent population the incidence of disseminated sporotrichosis was low,resulting misdiagnosis and mistreatment.The tissue culture was superior to the pus culture for the diagnosis of sporotrichosis.

关 键 词：孢子丝菌病 播散型 声嘶 

分 类 号：R519.8[医药卫生—内科学]