Soki Hironobu, Nagase Yoshitaka, Yamazaki Kenichiro, Oda Toshimi, Kikuchi Ken
Department of Clinical Laboratory, Saitama Red Cross Hospital.
Kansenshogaku Zasshi. 2010 Mar;84(2):210-2. doi: 10.11150/kansenshogakuzasshi.84.210.
As longer lives have become possible due to advances in medical technology and diagnostic technology in recent years, weakly toxic fungus have been emerging as causative agents of opportunistic infections, primarily in high-risk groups. We report a case in which the yeast-like fungus Stephanoascus ciferii, which has morphological characteristics that differ from those of the more common Candida species, was isolated by culturing the aural discharge of a patient with intractable otitis media. Drug susceptibility testing showed that it was resistant to fluconazole, flucytosine, and itraconazole, suggesting that it is a species that has a strong tendency to become resistant. The principal sites of infection by Stephanoascus ciferii are thought to be in the ENT area, but in other countries it has been isolated from patients with acute myeloid leukemia and immunodeficiency as well as superficial mycoses, and it may also be a causative agent of deep mycoses. We therefore think that it is necessary to bear in mind detection in other areas outside the ENT field and to adequately monitor the circumstances under which this fungus is isolated.
近年来,由于医学技术和诊断技术的进步,人们的寿命得以延长,弱毒性真菌已逐渐成为机会性感染的病原体,主要发生在高危人群中。我们报告了一例病例,通过培养一名患有顽固性中耳炎患者的耳部分泌物,分离出了形态特征与较常见念珠菌属不同的酵母样真菌西弗拟青霉。药敏试验表明,它对氟康唑、氟胞嘧啶和伊曲康唑耐药,提示这是一种具有较强耐药倾向的菌种。西弗拟青霉的主要感染部位被认为是耳鼻喉区域,但在其他国家,它也从急性髓系白血病和免疫缺陷患者以及浅表真菌病患者中分离出来,并且它也可能是深部真菌病的病原体。因此,我们认为有必要留意在耳鼻喉领域以外的其他区域进行检测,并充分监测分离出这种真菌的情况。