Harish K, Harikumar R, Aravindan K P, Varghese Thomas
Departments of Gastroenterology and Pathology, Medical College Hospital, Kozhikode 673 008, Kerala.
Trop Gastroenterol. 2004 Oct-Dec;25(4):172-3.
We report a case of systemic phaeohyphomycosis in a 13-year old girl. The clinical presentation was with fever, weight loss, cholestatic jaundice with hepatosplenomegaly and generalized lymphadenopathy. The patient was diagnosed initially as tuberculous adenitis and was on antituberculous therapy, but with worsening of symptoms. Lymph node and liver biopsy showed granuloma with fungal hyphae suggestive of phaeohyphomycosis. The patient responded to antifungal therapy. Later she developed secondary biliary cirrhosis with cholangitis due to long stricture of the common bile duct and common hepatic duct requiring biliary stenting. To the best of our knowledge, this is the first report on phaeohyphomycosis causing biliary cirrhosis in the English lilterature.
我们报告一例13岁女孩的系统性暗色丝孢霉病。临床表现为发热、体重减轻、伴有肝脾肿大和全身淋巴结病的胆汁淤积性黄疸。该患者最初被诊断为结核性腺炎并接受抗结核治疗，但症状仍加重。淋巴结和肝脏活检显示肉芽肿伴有真菌菌丝，提示暗色丝孢霉病。患者对抗真菌治疗有反应。后来，由于胆总管和肝总管长期狭窄，她发展为继发性胆汁性肝硬化并伴有胆管炎，需要进行胆道支架置入术。据我们所知，这是英文文献中关于暗色丝孢霉病导致胆汁性肝硬化的首例报告。
