Vilela Raquel, Souza Guenael F, Fernandes Cota Gláucia, Mendoza Leonel
Hospital Eduardo de Menezes, Medical Mycology Laboratory, Belo Horizonte, Brazil.
Rev Iberoam Micol. 2007 Jun;24(2):161-3. doi: 10.1016/s1130-1406(07)70035-9.
A male patient with HIV and past history of tuberculosis and suspected neurotoxoplasmosis was admitted to the hospital with vomiting and small nodules through all his body. Few of the nodules were found forming chains of enlarged lymphatic vessels, especially on lesions located on the limbs. Some of the nodules were ulcerated with a serosanguineous discharge. Collected samples from ulcerated and the nodular lesions showed the presence of Sporothrix schenckii in culture. Although all hemocultures were negative, a spinal fluid collected from this patient and cultures from the cutaneous lesions were both positive for S. schenckii. The patient showed improvement after treatment with Amphotericin B. Sadly, he later died of complications not related to the S. schenckii infection. This case of disseminated sporotrichosis is a remainder that in patients with immunological disorders exotic forms of this fungal clinical entity could be expected.
一名患有艾滋病病毒且有结核病病史、疑似神经型弓形虫病的男性患者因呕吐和全身出现小结节入院。发现少数结节形成了淋巴管增粗的链状结构,尤其是在四肢的病变处。一些结节发生溃疡,有血清血液样分泌物。从溃疡和结节性病变处采集的样本在培养物中显示存在申克孢子丝菌。尽管所有血培养均为阴性,但从该患者采集的脑脊液以及皮肤病变培养物中申克孢子丝菌均呈阳性。患者接受两性霉素B治疗后病情有所改善。遗憾的是,他后来死于与申克孢子丝菌感染无关的并发症。这例播散性孢子丝菌病病例提醒我们,对于免疫功能紊乱的患者,可能会出现这种真菌临床实体的特殊形式。