Segner S, Jouret F, Durant J-F, Marot L, Kanaan N
Division of Dermatology, Université catholique de Louvain, Brussels, Belgium.
Transpl Infect Dis. 2009 Aug;11(4):330-2. doi: 10.1111/j.1399-3062.2009.00420.x. Epub 2009 Jul 5.
Skin lesions are common in renal transplant recipients (RTR) and the clinical distinction of malignancy versus infection may be difficult in this patient population, with the need for further histological and biological investigations. We report here on a 73-year-old male RTR who presented with Alternaria infectoria phaeohyphomycosis of 1 year's duration. Mycological cultures were negative, and the diagnosis was performed by real-time polymerase chain reaction assay and direct sequencing. The extension of the lesion under itraconazole treatment required its surgical excision. Alternaria are ubiquitous plant-inhabiting saprobes, which are increasingly associated with opportunistic phaeohyphomycosis in immunocompromised individuals.
皮肤病变在肾移植受者(RTR)中很常见,在这一患者群体中,区分恶性肿瘤与感染的临床诊断可能很困难,需要进一步进行组织学和生物学检查。我们在此报告一名73岁男性肾移植受者,他患有持续1年的链格孢菌暗色丝孢霉病。真菌培养结果为阴性,诊断通过实时聚合酶链反应检测和直接测序进行。在伊曲康唑治疗下病变仍有扩展,因此需要手术切除。链格孢菌是普遍存在于植物中的腐生菌,越来越多地与免疫功能低下个体的机会性暗色丝孢霉病相关。