Passeron T, Barberet P, Colbachini P, Hovette P, Lacour J P
CHU de Nice, Hôpital de l'Archet 2, Service de Dermatologie, 151 Rte de St-Antoine de Ginestière, BP 3079, 06202 Nice.
Med Trop (Mars). 2003;63(6):614-6.
A 68-year-old cattle farmer from northern Senegal sought medical attention for tumefaction that had been progressing on the right foot and leg for 20 years. Physical examination of the right extremity revealed very firm tumefaction involving the foot and whole leg associated with numerous nodules. Bone radiographs and CT-scan of the foot and leg disclosed extensive osteolytic involvement. A specimen of squamous tissue from the top of nodules showed the presence of fumagoid cells characteristic of chromomycosis. Histologic examination after skin biopsy demonstrated fungal myocetoma. Due to the extent of involvement surgical and antifungal treatment was proposed but the patient refused to undergo surgery. Only one previous case of concurrent chromomycosis and mycetoma has been described. However the previous case involved actinomycetoma. The rarity of this combination of diseases despite their common contamination mode is due to different geographical distribution with mycetoma being found in the Sahelian region and chromomycosis in the humid equatorial region.
一名来自塞内加尔北部的68岁养牛农民因右脚和腿部逐渐肿大20年而就医。对其右下肢进行体格检查发现，足部和整条腿部出现非常坚硬的肿胀，并伴有大量结节。足部和腿部的骨X光片及CT扫描显示有广泛的骨质溶解病变。取自结节顶部的鳞状组织标本显示存在着色芽生菌病特有的烟曲霉样细胞。皮肤活检后的组织学检查证实为真菌性足菌肿。鉴于病变范围，建议进行手术和抗真菌治疗，但患者拒绝接受手术。此前仅报道过1例着色芽生菌病和足菌肿并发的病例。不过，之前的病例为放线菌性足菌肿。尽管这两种疾病的感染途径相同，但这种疾病组合的罕见性是由于它们的地理分布不同，足菌肿见于萨赫勒地区，而着色芽生菌病见于潮湿的赤道地区。
