Minagawa Yui, Konohana Izumi
Department of Dermatology, Hiratsuka City Hospital, Kanagawa, Japan.
Nihon Ishinkin Gakkai Zasshi. 2005;46(3):183-6. doi: 10.3314/jjmm.46.183.
Alternaria is a saprophytic fungus that naturally subsists on decaying plant materials, but may be an opportunistic pathogen in immunocompromised hosts. We describe a case of dermal cutaneous alternariosis in a 70-year-old patient, who was on systemic steroid administration for autoimmune hemolytic anemia. The patient also had chronic heart failure, liver dysfunction, and diabetes mellitus. Infection was confirmed by histological examination, and multiple positive culture results. Treatment with oral terbinafine and itraconazole was ineffective. We review the literature of dermal cutaneous alternariosis reported in Japan; including our case, 15 cases have been reported. Recognition of Alternaria as a potential opportunistic pathogen is important for the differential diagnosis of dermatologic lesion, such as granulomatous lesion or ulcer, in immunocompromised hosts.
链格孢属是一种腐生真菌，自然存在于腐烂的植物材料上，但在免疫功能低下的宿主中可能是机会性病原体。我们描述了一例70岁患者的皮肤链格孢病病例，该患者因自身免疫性溶血性贫血正在接受全身性类固醇治疗。该患者还患有慢性心力衰竭、肝功能不全和糖尿病。通过组织学检查和多次阳性培养结果确诊感染。口服特比萘芬和伊曲康唑治疗无效。我们回顾了日本报道的皮肤链格孢病的文献；包括我们的病例在内，已报道15例。认识到链格孢属作为潜在的机会性病原体对于免疫功能低下宿主中皮肤病损（如肉芽肿性病变或溃疡）的鉴别诊断很重要。
