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[养老院中发生的紫色毛癣菌感染]

[Trichophyton violaceum infection occurring in a nursing home].

作者信息

Kakutani Hiroyuki, Kakutani Takako, Mochizuki Takashi

机构信息

Aioi Dermatological Clinic, Yamagata, and Department of Dermatology, Kanazawa Medical University, Ishikawa, Japan.

出版信息

Nihon Ishinkin Gakkai Zasshi. 2005;46(4):279-84. doi: 10.3314/jjmm.46.279.

Abstract

Six cases of Trichophyton (T.) violaceum infection seen in a nursing home are reported. A 66-year-old female (case 1) was found with tinea corporis on her face, chest and shoulder, associated with black dot ringworm. A KOH examination of hair showed endothrix parasitism. Reddish purple colonies were isolated from the patient on Sabouraud's dextrose agar, and intercalary and terminal chlamydospores were observed on slide culture. PCR-RFLP analysis of the microorganism showed a pattern of T. violaceum type. Therefore, the isolated fungus was identified as T. violaceum, a typical anthropophilic dermatophyte which had spread among residents and staffs easily. Using a mycological method, we examined 59 persons (21 residents and 38 staff members) who had had contact with case 1. The results were as follows. An 85-year-old female (case 2) and an 83-year-old female (case 3) were carriers of T. violaceum. A 23-year-old male (case 4) had tinea corporis on his right forearm due to T. violaceum. A 24-year-old male (case 5) probably had tinea corporis on his right forearm due to T. violaceum. One year after case 1's first visit to our clinic, we observed an 88-year-old female (case 6) of tinea capitis by T. violaceum. It seems that the organism was preserved in surroundings and members of the nursing home. The contagion in our cases could either have been caused by directly touching the person or by sharing their comb. PCR-RFLP analysis was performed within a short time, so that we managed effectively to select a way of treatment and to prevent the infection from spreading.

摘要

报告了在一家养老院中发现的6例紫色毛癣菌感染病例。一名66岁女性(病例1)面部、胸部和肩部出现体癣,伴有黑点癣。毛发的氢氧化钾检查显示发内寄生。在沙氏葡萄糖琼脂上从患者分离出紫红色菌落,玻片培养观察到间生和顶生厚壁孢子。对该微生物的聚合酶链反应-限制性片段长度多态性分析显示为紫色毛癣菌型模式。因此,分离出的真菌被鉴定为紫色毛癣菌,这是一种典型的嗜人型皮肤癣菌,很容易在居民和工作人员中传播。我们采用真菌学方法对与病例1有接触的59人(21名居民和38名工作人员)进行了检查。结果如下。一名85岁女性(病例2)和一名83岁女性(病例3)是紫色毛癣菌携带者。一名23岁男性(病例4)右前臂因紫色毛癣菌感染出现体癣。一名24岁男性(病例5)右前臂可能因紫色毛癣菌感染出现体癣。病例1首次就诊我们诊所一年后,我们观察到一名88岁女性(病例6)因紫色毛癣菌感染患头癣。看来该病原体在养老院的环境和人员中留存。我们这些病例中的传染可能是通过直接接触该人或共用梳子引起的。在短时间内进行了聚合酶链反应-限制性片段长度多态性分析,以便我们有效地选择治疗方法并防止感染传播。

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