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球毛壳菌引起的甲癣

Onychomycosis Caused by Chaetomium globosum.

作者信息

Kim Dong Min, Lee Myung Hoon, Suh Moo Kyu, Ha Gyoung Yim, Kim Heesoo, Choi Jong Soo

机构信息

Department of Dermatology, College of Medicine, Dongguk University, Gyeongju, Korea.

出版信息

Ann Dermatol. 2013 May;25(2):232-6. doi: 10.5021/ad.2013.25.2.232. Epub 2013 May 10.

DOI:10.5021/ad.2013.25.2.232
PMID:23717019
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3662921/
Abstract

Onychomycosis is usually caused by dermatophytes, but some nondermatophytic molds and yeasts are also associated with invasion of nails. The genus Chaetomium is a dematiaceous nondermatophytic mold found in soil and plant debris as a saprophytic fungus. We report the first Korean case of onychomycosis caused by Chaetomium globosum in a 35-year-old male. The patient showed brownish-yellow discoloration and subungual hyperkeratosis on the right toenails (1st and 5th) and left toenails (1st and 4th). Direct microscopic examination of scraping on the potassium hydroxide preparation revealed septate hyphae and repeated cultures on Sabouraud's dextrose agar (SDA) without cycloheximide slants showed the same fast-growing colonies, which were initially velvety white then turned to dark gray to brown. However, there was no growth of colony on SDA with cycloheximide slants. Brown-colored septated hyphae, perithecia and ascospores were shown in the slide culture. The DNA sequence of internal transcribed spacer region of the clinical sample was a 100% match to that of C. globosum strain ATCC 6205 (GenBank accession number EF524036.1). We confirmed C. globosum by KOH mount, colony, and light microscopic morphology and DNA sequence analysis. The patient was treated with 250 mg oral terbinafine daily and topical amorolfine 5% nail lacquer for 3 months.

摘要

甲癣通常由皮肤癣菌引起，但一些非皮肤癣菌的霉菌和酵母菌也与指甲感染有关。毛壳菌属是一种在土壤和植物残体中作为腐生真菌发现的暗色非皮肤癣菌霉菌。我们报告了首例韩国男性由球形毛壳菌引起的甲癣病例。该患者右脚趾甲（第1和第5趾）和左脚趾甲（第1和第4趾）出现棕黄色变色和甲下角化过度。在氢氧化钾制剂上刮取物的直接显微镜检查显示有隔菌丝，在不含放线菌酮斜面的沙氏葡萄糖琼脂（SDA）上反复培养显示出相同的快速生长菌落，最初是天鹅绒白色，然后变为深灰色至棕色。然而，在含放线菌酮斜面的SDA上没有菌落生长。玻片培养显示有棕色分隔菌丝、子囊壳和子囊孢子。临床样本内部转录间隔区的DNA序列与球形毛壳菌菌株ATCC 6205（GenBank登录号EF524036.1）的序列100%匹配。我们通过氢氧化钾涂片、菌落、光学显微镜形态和DNA序列分析确认了球形毛壳菌。该患者接受了每日250毫克口服特比萘芬和外用5%阿莫罗芬搽剂治疗3个月。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/44915e1d310c/ad-25-232-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/92cd8795f283/ad-25-232-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/97b9b58bd9aa/ad-25-232-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/d1f5165a5761/ad-25-232-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/00f502965630/ad-25-232-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/3b67c35fc2ea/ad-25-232-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/5c0dd1dfebd8/ad-25-232-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/fa08304d730a/ad-25-232-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/4e7cbb2e8540/ad-25-232-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/44915e1d310c/ad-25-232-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/92cd8795f283/ad-25-232-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/97b9b58bd9aa/ad-25-232-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/d1f5165a5761/ad-25-232-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/00f502965630/ad-25-232-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/3b67c35fc2ea/ad-25-232-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/5c0dd1dfebd8/ad-25-232-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/fa08304d730a/ad-25-232-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/4e7cbb2e8540/ad-25-232-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3962/3662921/44915e1d310c/ad-25-232-g009.jpg

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