肝移植术后根霉病1例  

Rhizopus: a case report

作　　者：奚丹[1] 金京姬[1] 曾三武[1] 高文新[1] 刘懿和[2] 赵文[2] 郑洪[2] 石玉秀[3] 李若瑜[4] 王端礼[4] 纪黎明[1] 

机构地区：[1]天津市第一中心医院皮肤病医院,天津300192 [2]天津市第一中心医院移植外科,天津300192 [3]天津医科大学总医院皮肤科,天津300180 [4]北京大学第一医院皮肤科,北京100034

出　　处：《临床皮肤科杂志》2003年第9期532-533,共2页Journal of Clinical Dermatology

摘　　要：报告1例皮肤根霉病。患者男,50岁。因丙型肝炎、肝硬化接受原位肝移植术。术后第12天,右上肢前臂出现红斑、肿胀并渐扩大,皮肤呈黑色坏疽样外观。右上肢、肩部、腋下、胸背疼痛。皮损组织病理检查示血管周围有粗大、无分隔直角菌丝,血管内真菌栓塞。真菌学检查证实为接合菌病根霉属。后经聚合酶链反应(PCR)鉴定为小孢根霉。对上肢感染组织行清创术、截肢,并予以两性霉素B脂质体治疗3周。经治疗肿胀减轻,疼痛消失,目前仍在治疗中。A 50-year-old patient with rhizopus is reported. He was operated on for in situ hepatic transplantation because of cirrhosis caused by hepatitis C. Twelve days after operation, erythema was noted on his right forearm, the lesion swelled and expanded gradually and became gangrenous and black in color. There was pain in the right upper limb, shoulder, axilla, chest and back. Mycological examination revealed the pathogen was Rhizopus spp. and finally identified as Rhizopus mi-crosporus through PCR. Histopathology showed that there were coarse rectangular hypae with no septation around the blood vessels and fungal embolism in blood vessels. Debridement of infected tissue of upper limb and amputation of 1/2 upper arm were performed. After 3 weeks of amphotericin B liposome treatment, swelling of the upper arm alleviated and pain disappeared. The treatment is still going on.

关 键 词：根霉病 皮肤 小孢根霉菌 脂质体两性霉素B 

分 类 号：R756[医药卫生—皮肤病学与性病学]