Néji S, Trabelsi H, Cheikhrouhou F, Sellami H, Guidara R, Trigui A, Feki J, Boudaya S, Turki H, Makni F, Ayadi A
Laboratoire de biologie moléculaire parasitaire et fongique, faculté de médecine, rue Magida Boulila, 3029 Sfax, Tunisie.
J Mycol Med. 2013 Jun;23(2):130-5. doi: 10.1016/j.mycmed.2013.04.003. Epub 2013 May 30.
The genus Fusarium, initially known for its important agro-economic impact, is more and more often implicated in human pathology. In fact, multiples allergic, toxic and infectious manifestations are more reported in immunocompetent and immunocompromised hosts. The objective of our study was to analyse the epidemiological, mycological and clinical features of fusariosis reported in our CHU. Eighty-seven cases of Fusarium infections were collected: 34 cases of onychomycosis (39%), 26 cases of intertrigos (30%), 25 cases of keratomycosis (29%), one case of atypical invasive fusariosis due to Fusarium oxysporum species complex (FOSC) and one case of localized gingivolabial fusariosis due to Fusarium solani species complex (FSSC) in a patient with leukemia in phase of deep bone marrow aplasia, whose outcome was favorable after exiting of aplasia period and a treatment by amphotericine B. The case of pseudotumoral cutaneous fusariosis to F. oxysporum complicated with osteolysis and septic arthritis occurred in a pregnant woman without any immune deficit. The evolution was fatal in spite of prescription of multiple systemic antifungals. Concerning keratomycosis, Fusarium was the first agent responsible for these infections (43%). The corneal traumatism was found in 37.5% of cases and FSSC was the most isolated (72%). For superficial dermatomycosis, Fusarium was the third agent of onychomycosis in molds (25%). The most isolated species were FSSC (68%) and FOSC (20%). The intertrigo frequency was 0.07% and they were mostly caused by FSSC (84%) and FOSC (16%). Fusarium is an important cause of mold infections in our region. So, the species identification is useful because some species are resistant to the most common systemic antifungal agents.
镰刀菌属最初因其对农业经济的重要影响而为人所知,现在越来越多地与人类病理学相关。事实上,在免疫功能正常和免疫功能低下的宿主中,多种过敏、毒性和感染性表现的报告越来越多。我们研究的目的是分析我们大学医院报告的镰刀菌病的流行病学、真菌学和临床特征。收集了87例镰刀菌感染病例:34例甲癣(39%)、26例擦烂(30%)、25例角膜真菌病(29%)、1例由尖孢镰刀菌种复合体(FOSC)引起的非典型侵袭性镰刀菌病和1例由茄病镰刀菌种复合体(FSSC)引起的局部牙龈唇镰刀菌病,该病例发生在一名处于深部骨髓再生障碍期的白血病患者中,在再生障碍期结束并接受两性霉素B治疗后预后良好。一名无任何免疫缺陷的孕妇发生了由尖孢镰刀菌引起的假性肿瘤性皮肤镰刀菌病,并发骨溶解和化脓性关节炎。尽管使用了多种全身性抗真菌药物,病情仍发展至致命。关于角膜真菌病,镰刀菌是这些感染的首要病原体(43%)。37.5%的病例存在角膜外伤,FSSC是最常分离出的菌种(72%)。对于浅表皮肤真菌病,镰刀菌是霉菌中甲癣的第三大病原体(25%)。最常分离出的菌种是FSSC(68%)和FOSC(20%)。擦烂的发生率为0.07%,主要由FSSC(84%)和FOSC(16%)引起。镰刀菌是我们地区霉菌感染的重要原因。因此,菌种鉴定很有用,因为有些菌种对最常用的全身性抗真菌药物耐药。