Mayayo Emilio, Stchigel Alberto M, Cano José F, Bernal-Escoté Xana, Guarro Josep
Unitat d'Anatomia Patològica, Facultat de Medicina i Ciències de la Salut, IISPV, Universitat Rovira i Virgili, Reus, Tarragona, España.
Rev Iberoam Micol. 2013 Jan 3;30(1):57-60. doi: 10.1016/j.riam.2012.06.002. Epub 2012 Jun 29.
Cutaneous mucormycosis (zygomycosis), with subcutaneous spreading and dissemination, in immunocompetent patients is an uncommon disease caused by species belonging to the fungal genera Apophysomyces, Rhizopus and Saksenaea, among others.
A case of necrotising fasciitis by Saksenaea vasiformis in an immunocompetent woman is described. The infection was acquired through a car accident resulting in multiple injuries affecting mainly her right arm. After the surgical reduction of fractures, skin lesions worsened and led to necrosis. The patient quickly developed a severe necrotising fasciitis with negative cultures at first. Despite the extensive surgical debridement and the aggressive antifungal treatment, the patient died. The histopathological study showed a fungal infection due to a fungus belonging to the Mucorales order, which was confirmed by culturing the clinical sample on Sabouraud agar, and identifying the species by cultures on Czapek-Dox agar, and sequencing of the ITS region of the ribosomal DNA.
This case confirm the presence of this fungus in Spain, the value of histopathology for the mucormycosis diagnosis, as well as the need to perform special cultures to facilitate their isolation and identification to the species level by the combined use of Czapek-Dox agar and sequencing of the ITS region.
在免疫功能正常的患者中，皮肤毛霉病（接合菌病）伴皮下扩散和播散是一种由顶孢霉属、根霉属和犁头霉属等真菌引起的罕见疾病。
描述了一例免疫功能正常的女性因犁头霉引起的坏死性筋膜炎。感染是通过一场主要导致其右臂多处受伤的车祸获得的。骨折手术复位后，皮肤损伤恶化并导致坏死。患者最初迅速发展为严重的坏死性筋膜炎，培养结果为阴性。尽管进行了广泛的手术清创和积极的抗真菌治疗，患者仍死亡。组织病理学研究显示由一种属于毛霉目的真菌引起的真菌感染，通过在沙氏琼脂上培养临床样本、在察氏琼脂上培养以鉴定菌种以及对核糖体DNA的ITS区域进行测序得以证实。
该病例证实了这种真菌在西班牙的存在、组织病理学在毛霉病诊断中的价值，以及通过联合使用察氏琼脂和ITS区域测序进行特殊培养以促进其分离和鉴定到种水平的必要性。
