Zhang Cathryn Z, Fung Maxwell A, Eisen Daniel B
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.
Dermatol Online J. 2009 Oct 15;15(10):5.
Fusarium is a filamentous fungus found naturally in the soil and as a contaminant of plumbing systems. In immunocompetent patients, Fusarium causes localized infection, most commonly onychomycosis. Fusarium tends to be resistant to commonly used antifungal medications. In immunocompromised patients, this antifungal resistance is of particular concern because localized infection quickly becomes disseminated disease with high mortality rates. Disseminated fusariosis presents with skin lesions more often than any other systemic fungal infection. We present a case of fusariosis in an 11-year-old neutropenic patient with acute lymphoblastic leukemia whose only symptom of the fungal infection consisted of painful, indurated nodules and plaques on her legs. The diagnosis and treatment of this invasive fungal infection is also discussed.
镰刀菌是一种丝状真菌，天然存在于土壤中，也是管道系统的污染物。在免疫功能正常的患者中，镰刀菌会引起局部感染，最常见的是甲癣。镰刀菌往往对常用的抗真菌药物耐药。在免疫功能低下的患者中，这种抗真菌耐药性尤其令人担忧，因为局部感染会迅速发展为播散性疾病，死亡率很高。播散性镰刀菌病比其他任何系统性真菌感染更常出现皮肤病变。我们报告一例11岁急性淋巴细胞白血病中性粒细胞减少患者的镰刀菌病病例，该真菌感染的唯一症状是腿部出现疼痛性硬结结节和斑块。本文还讨论了这种侵袭性真菌感染的诊断和治疗。
