CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands.
Med Mycol. 2010 Aug;48(5):696-703. doi: 10.3109/13693780903471073.
We report a case of chromoblastomycosis which resembled sporotrichosis due to the presence of warty nodules and lymphatic distribution on the forearm in a 56-year-old male. Mycological and histopathological investigation of exudates and biopsy tissue samples revealed a granulomatous lesion with muriform cells, the hallmark of chromoblastomycosis. The infection showed only localized expansion with verrucous plaques suggesting a new clinical type of the disease. The causative agent was identified as Rhinocladiella aquaspersa. This case prompted a study of the clinical spectrum of R. aquaspersa, through which we identified a second case caused by this fungus in a 62-year-old Brazilian female. The case was unusual in that R. aquaspersa exhibited hyphae rather than muriform cells in tissue. Given the difficulties treating chromoblastomycosis and other infections caused by melanized fungi, we evaluated the in vitro activities of extended-spectrum triazoles, amphotericin B, and echinocandins against these clinical isolates of R. aquaspersa. Itraconazole (MIC; 0.063 mg/l) and posaconazole (MIC; 0.125 mg/l) had the highest in vitro activities, while voriconazole and isavuconazole had somewhat lower activities (MICs; 2 mg/l) against the isolates. Amphotericin B and anidulafungin each had an MIC of 1 mg/l, whereas the MIC of caspofungin was 8 mg/l.
我们报告了一例酷似孢子丝菌病的着色芽生菌病,患者为 56 岁男性,前臂出现疣状结节和淋巴管分布。渗出物和活检组织样本的真菌学和组织病理学研究显示出一种肉芽肿性病变,具有多形态细胞,这是着色芽生菌病的标志。感染仅表现为局限性扩张,伴有疣状斑块,提示为该病的一种新临床类型。病原体被鉴定为 Rhinocladiella aquaspersa。该病例促使我们研究了 R. aquaspersa 的临床谱,通过该研究,我们在一名 62 岁巴西女性中发现了第二例由该真菌引起的病例。该病例不寻常之处在于组织中 R. aquaspersa 表现为菌丝而不是多形态细胞。鉴于治疗着色芽生菌病和其他黑色素真菌引起的感染存在困难,我们评估了广谱三唑类、两性霉素 B 和棘白菌素类药物对这些临床分离株 R. aquaspersa 的体外活性。伊曲康唑(MIC;0.063 mg/l)和泊沙康唑(MIC;0.125 mg/l)具有最高的体外活性,而伏立康唑和艾沙康唑的活性略低(MIC;2 mg/l)。两性霉素 B 和安尼卡fungin 的 MIC 均为 1 mg/l,而卡泊芬净的 MIC 为 8 mg/l。