Hattori Hisao, Inoue Chisa, Tomita Yasushi, Kanbe Toshio
Department of Dermatology, Nagoya Graduate School of Medicine, Aichi 466-8550, Japan.
Jpn J Infect Dis. 2007 Sep;60(5):300-1.
Geotrichosis is an uncommon fungal infection. Geotrichum capitatum is commonly acknowledged as an opportunistic fungal pathogen that causes systemic geotrichosis in immunocompromised patients, especially patients with acute leukemia and severe neutropenia. Here, we report a case of oral geotrichosis caused by G. capitatum in an old patient with no hematological malignancies. Fungal cells were detected in clinical specimens obtained with oral swabs using the KOH technique. Yeast colonies with peripheral hairs were exclusively isolated as fungi from the oral mucosa and feces of the patient. The isolates were identified as G. capitatum by morphological findings, sugar-assimilation tests, and the nucleotide sequences of the ITS regions of the rDNA. Effective treatment of the patient was achieved with amphotericin B syrup in accord with the results of in vitro susceptibility tests. G. capitatum should be recognized as a fungal pathogen involved in superficial infections of older persons, as should Candida spp., even in the absence of hematological malignancies.
地霉病是一种罕见的真菌感染。头状地霉通常被认为是一种机会性真菌病原体,可在免疫功能低下的患者中引起全身性地霉病,尤其是急性白血病和严重中性粒细胞减少症患者。在此,我们报告一例由头状地霉引起的口腔地霉病,患者为一名无血液系统恶性肿瘤的老年患者。使用氢氧化钾(KOH)技术在口腔拭子获取的临床标本中检测到真菌细胞。仅从患者的口腔黏膜和粪便中分离出带有外周毛发的酵母菌落作为真菌。通过形态学观察、糖同化试验以及核糖体DNA(rDNA)内转录间隔区(ITS)的核苷酸序列,将分离株鉴定为头状地霉。根据体外药敏试验结果,使用两性霉素B糖浆对患者进行了有效治疗。头状地霉应被视为与老年人浅表感染有关的真菌病原体,念珠菌属也是如此,即使在无血液系统恶性肿瘤的情况下。