多部位感染不同基因型红色毛癣菌1例  

Analysis of Trichophyton rubrum infection with different genotypes at multiple sites in the same patient

作　　者：郑文爱 乔凤 唐小正 ZHENG Wenai;QIAO Feng;TANG Xiaozheng(The Fifth People’s Hospital of Hainan Province,Haikou 570206,China)

机构地区：[1]海南省第五人民医院,海口570206

出　　处：《中国真菌学杂志》2025年第1期66-68,72,共4页Chinese Journal of Mycology

基　　金：海南省卫生健康行业科研项目(22A200285);海南省临床医学中心建设项目。

摘　　要：患者,男,56岁,因“面部、躯干、四肢散在褐色斑块6个月余”在我院门诊就诊。患者6个月前无诱因四肢、躯干出现褐色斑块状皮损,后来面部也出现褐色皮损,瘙痒感较轻。荧光钙白染色镜检可见绿色荧光的有隔菌丝和圆形、?圆形孢子,真菌培养鉴定为红色毛癣菌,诊断为红色毛癣菌所致泛发性体股癣。外用特比萘芬乳膏和硝酸咪康唑洗剂治疗2个月,原有皮损基本痊愈,但面部和臀部原皮损处有新发的零星的红色丘疹。从患者身上分离的6株菌株经ITS测序鉴定为红色毛癣菌,且种内DNA分型具有不同的基因型,提示同一患者在局部不同部位可能感染不同类型的红色毛癣菌。A 56-year-old male patient presented at the outpatient department of our hospital due to"scattered brown patches on the face,trunk,and limbs for more than 6 months".Six months ago,the patient had brown patch-like skin lesions on the limbs and trunk without any inducement,and then brown skin lesions also appeared on the face,with a relatively mild pruritus.Under microscopic examination with calcium fluorescence white staining,septate hyphae with green fluorescence and round,elliptical spores could be seen.Fungal culture identified it as Trichophyton rubrum,and the diagnosis was generalized tinea corporis and tinea cruris caused by T.rubrum.After 2 months of treatment with topical terbinafine cream and miconazole nitrate lotion,the original skin lesions basically healed,but there were new sporadic red papules at the original skin lesion sites on the face and buttocks.The six strains isolated from the patient were identified as T.rubrum through ITS sequencing,and had different genotypes in intraspecific DNA typing,suggesting that the same patient in the local area can be infected with different types of Trichophyton rubrum in different parts.

关 键 词：红色毛癣菌 TRS 基因型 同源性 

分 类 号：R756.2[医药卫生—皮肤病学与性病学]