Demiraslan Hayati, Alabay Selma, Kilic Aysegul Ulu, Borlu Murat, Doganay Mehmet
Department of Infectious Diseases, Erciyes University, Kayseri, Turkey.
Int J STD AIDS. 2013 Sep;24(9):753-5. doi: 10.1177/0956462413479897. Epub 2013 Jul 8.
Cutaneous Candida infections may occur in patients with HIV/AIDS, cancer, receiving chemotherapy and solid organ transplantation. A 32-year-old woman was admitted to the department suffering from pruritic and erythematous plaque on left side of her face for the past two months. The patient was HIV positive, diagnosed five years previously, and had been on antiretroviral therapy (tenofovir/emtricitabine and lopinavir/ritonavir) for a year. She was not compliant with the medication. Elevated HIV RNA load and decreased CD4+ lymphocyte count were observed. Fungal elements were detected from the skin scraping sample taken from the facial plaque. Fluconazole-sensitive Candida glabrata was isolated from this sample. Topical clotrimazole ointment and systemic fluconazole 400 mg/day were used. After systemic fluconazole therapy was continued for two months, the plaque was cured. C. glabrata rarely causes cutaneous infection without involving the mucous membranes. Presentation of cutaneous fungal infections in HIV patients with decreased CD4+ T lymphocyte counts can be atypical and require extensive antifungal treatment.
皮肤念珠菌感染可能发生在艾滋病毒/艾滋病患者、癌症患者、接受化疗的患者以及实体器官移植患者中。一名32岁女性因左侧面部瘙痒性红斑斑块两个月而入院。该患者艾滋病毒呈阳性，五年前确诊，已接受抗逆转录病毒治疗（替诺福韦/恩曲他滨和洛匹那韦/利托那韦）一年。她未遵医嘱服药。观察到艾滋病毒RNA载量升高，CD4 +淋巴细胞计数降低。从面部斑块采集的皮肤刮屑样本中检测到真菌成分。从该样本中分离出对氟康唑敏感的光滑念珠菌。使用了外用克霉唑软膏和每日400毫克的全身性氟康唑。全身性氟康唑治疗持续两个月后，斑块治愈。光滑念珠菌很少在不涉及粘膜的情况下引起皮肤感染。CD4 + T淋巴细胞计数降低的艾滋病毒患者的皮肤真菌感染表现可能不典型，需要进行广泛的抗真菌治疗。
