Mehta Karan Inder Singh, Sharma Nand Lal, Kanga Anil K, Mahajan Vikram K, Ranjan Nitin
Department of Dermatology, Venereology and Leprosy, India Gandhi Medical College, Shimla, Himachal Pradesh, India.
Mycoses. 2007 Nov;50(6):496-501. doi: 10.1111/j.1439-0507.2007.01411.x.
Himachal Pradesh, India is a known endemic area for cutaneous sporotrichosis. No attempt has been made to isolate Sporothrix schenckii, the causative fungus, from environmental sources in this region or in India as such. This prospective study was carried out to isolate Sporothrix schenckii from different environmental samples collected from the vicinity of cutaneous sporotrichosis patients. All patients of cutaneous sporotrichosis diagnosed during March 2005-February 2006 were studied. Twenty-one biopsy specimens and 62 environmental samples of soil, various thorns, corn-stalk, grass-blades and sphagnum moss were subjected to mycologic culture on Sabouraud's glucose agar. Sporothrix schenckii was identified by colony characteristics, lacto-phenol cotton blue mounts and demonstration of temperature dimorphism. These patients (F : M 15 : 6) were between 12 and 72 years of age and had cutaneous lesions for 45 days to 4 years. Lymphocutaneous and fixed cutaneous sporotrichosis was seen in 14 (66.6%) and 7 (33.3%) patients respectively. Extremities were involved in 16 (76.2%); and 5 (23.8%) patients had facial lesions. Ten (47.4%) biopsy specimens and six environmental (three soil, three corn-stalk) samples were culture-positive, which showed morphological characteristics suggesting Sporothrix schenckii. No variation in colony characteristics and mycelial morphology was observed in growth isolates from clinical or environmental samples. Temperature dimorphism was observed in all the 10 isolates obtained from the clinical specimens and in two isolates cultured from corn-stalk. Corn-stalks are evidently important sources of Sporothrix schenckii infection although subsequent contamination of wounds appears more important for development of clinical disease. Culture of Sporothrix schenckii from environmental sources may not be always possible to correlate with profile of injuries.
印度喜马偕尔邦是已知的皮肤孢子丝菌病流行地区。此前尚未有人尝试从该地区或印度的环境来源中分离出致病真菌申克孢子丝菌。本前瞻性研究旨在从皮肤孢子丝菌病患者附近采集的不同环境样本中分离出申克孢子丝菌。对2005年3月至2006年2月期间诊断为皮肤孢子丝菌病的所有患者进行了研究。将21份活检标本以及62份土壤、各种刺、玉米秸秆、草叶和泥炭藓等环境样本接种于沙氏葡萄糖琼脂进行真菌培养。通过菌落特征、乳酸酚棉蓝涂片及温度双相性检测来鉴定申克孢子丝菌。这些患者(女性∶男性为15∶6)年龄在12至72岁之间,皮肤损害持续45天至4年。分别有14例(66.6%)和7例(33.3%)患者表现为淋巴管型和固定型皮肤孢子丝菌病。16例(76.2%)患者病变累及四肢;5例(23.8%)患者面部有损害。10份(47.4%)活检标本和6份环境样本(3份土壤、3份玉米秸秆)培养呈阳性,显示出提示申克孢子丝菌的形态特征。临床样本和环境样本的培养分离株在菌落特征和菌丝形态上未观察到差异。从临床标本获得的所有10株分离株以及从玉米秸秆培养的2株分离株均观察到温度双相性。玉米秸秆显然是申克孢子丝菌感染的重要来源,不过伤口随后受到污染对临床疾病的发生似乎更为重要。从环境来源培养申克孢子丝菌可能并不总是能够与损伤情况相关联。