Dermatology Residency Program, University Hospital of Brasilia, Universidade de Brasília, Brasília, Brazil.
Braz J Infect Dis. 2011 May-Jun;15(3):288-92. doi: 10.1016/s1413-8670(11)70191-x.
Aureobasidium pullulans is a causal agent of phaeohyphomycosis, occasionally found in men and animals. As an agent of different opportunistic fungal processes, it may cause fungemia, systemic infections and abscesses in different viscera. This paper aims to report a case of a patient with infection of the lymphatic system by A. pullulans. A 23-year-old patient being treated for erythema nodosum leprosum presented a 60-day complaint of daily fever, hoarseness, odynophagia and weight loss. Laboratory tests showed pancytopenia with severe neutropenia, cervical adenomegaly and solid contrast uptake lesion in the oropharyngeal region. Due to neutropenia and sepsis the patient was initially treated with cefepime and vancomycin, but there was no clinical improvement. Lymph node puncture-aspiration showed yeast-form fungus identified as A. pullulans by sequencing ITS region. The patient was treated with amphotericin B deoxycholate, leading to complete recovery of bone marrow function and regression of adenomegaly and the oropharyngeal lesion.
出芽短梗霉是一种假丝酵母菌，偶尔在人和动物中发现。作为不同机会性真菌感染的病原体，它可能导致真菌血症、全身性感染和不同内脏器官的脓肿。本文旨在报告一例由出芽短梗霉引起的患者的淋巴系统感染。一名 23 岁的患者正在接受红斑狼疮结节性治疗，出现 60 天的每日发热、声音嘶哑、咽痛和体重减轻。实验室检查显示全血细胞减少症伴严重中性粒细胞减少症、颈淋巴结肿大和口咽区域实性对比摄取病变。由于中性粒细胞减少症和脓毒症，患者最初接受头孢吡肟和万古霉素治疗，但无临床改善。淋巴结穿刺抽吸显示酵母样真菌，通过 ITS 区测序鉴定为出芽短梗霉。患者接受两性霉素 B 脱氧胆酸盐治疗，导致骨髓功能完全恢复，颈淋巴结肿大和口咽病变消退。
