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中国东北地区婴儿孢子丝菌病 15 例报告

Infant sporotrichosis in northeast China: a report of 15 cases.

机构信息

Department of Dermatology and Venereology, First Hospital of Jilin University, Changchun, Jilin, China.

出版信息

Int J Dermatol. 2011 May;50(5):522-9. doi: 10.1111/j.1365-4632.2010.04724.x.

Abstract

BACKGROUND

Sporotrichosis is a deep mycosis caused by Sporothrix schenckii. It is not uncommon in adults and children but is very rare in infants.

METHODS

We collated a series of case reports. Clinical data and laboratory and therapeutic results in 15 infants with cutaneous sporotrichosis were analyzed.

RESULTS

A total of 15 cases of sporotrichosis in infants aged <10 months (mean age: 5.2 months; 10 male, five female) were diagnosed at the Department of Dermatology and Venereology, First Hospital of Jilin University, Changchun, Jilin, China, between May 2007 and May 2009. The mean duration of the disease was 2.07 months (range: 1-4 months). All the patients had facial involvement. Fixed cutaneous and lymphocutaneous sporotrichosis were seen in 11 (73.3%) and four (26.7%) patients, respectively. All patients lived in rural areas and had not experienced prior trauma or had contact with soil, plants, animals, or other sporotrichosis patients. Sporothrix schenckii was isolated in all cases, and pathological findings showed suppurative granuloma, tuberculoid granuloma, or mixed inflammatory reaction. One of the 15 patients achieved a spontaneous resolution after biopsy. Fourteen were treated with oral agents, including potassium iodide (KI) alone in two cases, itraconazole alone in three cases, terbinafine alone in four cases, and a combination of KI and terbinafine in five cases. Twelve cases were followed for 4-24 months and were cured with a mean of 2.96 months of treatment (range: 2-4 months) without adverse effects.

CONCLUSIONS

Infant sporotrichosis usually presents as a solitary lesion on the face. This is the largest series of infant sporotrichosis to be reported in the literature.

摘要

背景

孢子丝菌病是由申克孢子丝菌引起的深部真菌病。成人和儿童中并不少见,但在婴儿中非常罕见。

方法

我们对一系列病例报告进行了整理。对 15 例婴儿皮肤孢子丝菌病的临床资料、实验室和治疗结果进行了分析。

结果

2007 年 5 月至 2009 年 5 月,中国吉林大学第一医院皮肤科共诊断出 15 例 10 个月以下婴儿孢子丝菌病(平均年龄:5.2 个月;男 10 例,女 5 例)。疾病的平均持续时间为 2.07 个月(范围:1-4 个月)。所有患者均有面部受累。11 例(73.3%)患者为固定性皮肤和淋巴管性孢子丝菌病,4 例(26.7%)为播散性皮肤孢子丝菌病。所有患者均生活在农村地区,且无外伤史,也无接触土壤、植物、动物或其他孢子丝菌病患者的病史。所有患者均培养出申克孢子丝菌,病理表现为化脓性肉芽肿、结核样肉芽肿或混合性炎症反应。15 例患者中有 1 例在活检后自行缓解。14 例患者接受了口服药物治疗,其中 2 例单独使用碘化钾(KI),3 例单独使用伊曲康唑,4 例单独使用特比萘芬,5 例联合使用 KI 和特比萘芬。12 例患者随访 4-24 个月,平均治疗 2.96 个月(范围:2-4 个月)后治愈,无不良反应。

结论

婴儿孢子丝菌病通常表现为面部孤立性病变。这是文献中报道的最大婴儿孢子丝菌病系列。

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