Sarazin F, Sainte-Marie D, Demar M, Aznar C, Sarrouy J, Pradinaud R, Carme B, Couppié P
Service de Dermatologie, Centre Hospitalier, Cayenne, Guyane Française.
Ann Dermatol Venereol. 2005 Feb;132(2):136-9. doi: 10.1016/s0151-9638(05)79225-5.
Paracoccidio-domycosisis a deep mycosis due to a dimorphic fungus:Paracoccidioides brasiliensis. The principle endemic country is Brazil. We describe the first case of paracoccidio-domycosis, in its cutaneous-mucosal form, diagnosed in French Guiana.
A 20 year-old Brazilian man, having mover to French Guiana a few months earlier, presented with multiple disseminated cutaneous lesions, predominating on the face, and composed of multiple nodules and two ulcerations. The clinical examination also revealed voluminous superficial lymph nodes and ulcerations of the pharynx and larynx. Direct examination, anatomopathology and culture of cutaneous biopsies revealed specific images of Paracoccidioides brasiliensis. HIV serology was negative. Treatment combining cotrimoxazole and itraconazole eliminated the lesions in one month.
Because the patient had just moved to Guiana, this observation probably corresponded to an imported disease. The principle differential diagnosis was leishmaniosis.
副球孢子菌病是由双相真菌巴西副球孢子菌引起的深部真菌病。主要流行国家是巴西。我们描述了在法属圭亚那诊断出的首例皮肤黏膜型副球孢子菌病病例。
一名20岁的巴西男子,几个月前移居法属圭亚那,出现多处播散性皮肤损害,主要集中在面部,由多个结节和两处溃疡组成。临床检查还发现浅表淋巴结肿大以及咽喉部溃疡。皮肤活检的直接检查、组织病理学检查和培养显示出巴西副球孢子菌的特征性图像。HIV血清学检查为阴性。复方新诺明和伊曲康唑联合治疗在一个月内消除了病变。
由于该患者刚移居到圭亚那,此病例可能为输入性疾病。主要的鉴别诊断是利什曼病。