1例外伤引起的尖端赛多孢菌感染的实验室检查及探索性临床治疗  

Laboratory examination and exploratory clinical treatment of a traumatic case of Scedosporium apiospermum infection

作　　者：辛少军[1] 沈翠芬[1] 汪艳[1] 金银[1] 朱吉超 XIN Shao-jun;SHEN Cui-fen;WANG Yan;JIN Yin;ZHU Ji-chao(Huzhou Central Hospital,Huzhou Key Laboratory of Precision Medicine Research and Transformation of Infectious Diseases,Zhejiang 313000,China)

机构地区：[1]湖州市中心医院,湖州市感染性疾病精准医学研究与转化重点实验室,浙江313000

出　　处：《中国卫生检验杂志》2023年第19期2343-2346,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的 探讨尖端赛多孢子菌感染的实验室检查特点及临床治疗方案。方法 回顾本院收治的1例因右膝外伤术后导致尖端赛多孢子菌感染患者的临床资料,总结对尖端赛多孢子菌感染的实验室检查进行分析。收集并整理各例尖端赛多孢子菌感染相关的临床治疗方案。结果 临床标本直接镜检均可见真菌菌丝。尖端赛多孢子菌在沙堡弱葡萄糖琼脂培养基(或者科玛嘉显色培养基)上,25℃、5%CO_(2)环境培养时,生长较迅速,起初菌落呈现白色棉絮状,经培养数天后,可见菌落中央逐渐变成褐色,且不断向四周扩散。同时结合乳酸酚棉蓝染色后的镜下形态特征、质谱分析或基因测序等检测方法对该菌进行快速鉴定。结论 尖端赛多孢子菌所致感染在临床上较为罕见,但因其病程较长,诊断困难,所以分析尖端赛多孢子菌感染的实验室检查特点和临床治疗方案,以加强临床和实验室对由尖端赛多孢子菌感染引起的各种疾病的认识,减短鉴定时间,提高诊治水平,降低患者死亡率。Objective This paper aims to investigate the laboratory characteristics and clinical treatment of Scedosporium apiospermum infection.Methods The clinical data of a patient with Scedosporium apiospermum infection after right knee trauma in our hospital was reviewed,and the laboratory examination of the infection was summarized and analyzed.The clinical treatment plans related to the infection were collected and sorted out.Results Fungal hyphae was found in all clinical specimens by direct microscopic examination.Scedosporium apiospermum grows rapidly when cultured on Sabourg weak glucose agar medium(or Komagar chromogenic medium)at 25℃in 5%CO_(2).White cotton wadding was observed in colony.After several days of culture,it can be seen that the center of the colony gradually turned brown and continued to spread around.Rapid identification of the strain was carried out by combining the morphological characteristics under microscope,mass spectrometry or gene sequencing after lactophenol cotton blue staining.Conclusion Infection caused by Scedosporium apiospermum is rare in clinic.However,due to the long course of the disease and the difficulty in diagnosis,the laboratory examination characteristics and clinical treatment plan of Scedosporium apiospermum infection are analyzed to strengthen the clinical and laboratory understanding of various diseases caused by Scedosporium apiospermum infection,shorten the identification time,improve the level of diagnosis and treatment,and reduce the mortality.

关 键 词：尖端赛多孢子菌 实验室检查特点 临床治疗 

分 类 号：R446.5[医药卫生—诊断学]