Hirayama Yoji, Yajima Nobuhisa, Kaimori Mitsuomi, Akagi Tomoaki, Kubo Komei, Saito Daisuke, Hizawa Yuki, Wada Ryuichi, Yagihashi Soroku
Department of Pathology and Molecular Medicine, Hirosaki University Graduate School of Medicine, Japan.
Intern Med. 2013;52(19):2275-9. doi: 10.2169/internalmedicine.52.0171. Epub 2012 Mar 1.
A 22-year-old Japanese woman was diagnosed with hemophagocytic lymphohistiocytosis and subsequently was treated with etoposide and cyclophosphamide. On Day 22, multiple nodular lesions appeared in the bilateral lungs. Neither the administered antibiotics nor the antifungal agent were effective, and she died suddenly of respiratory failure on Day 35. An autopsy revealed disseminated zygomycosis and a pulmonary infarction due to the embolization of an angioinvasive fungus, which was later identified as Cunninghamella bertholletiae using in situ hybridization of 18S rRNA. C. bertholletiae is aggressive as well as resistant to antifungal agents. This rare species should therefore be taken into consideration as a potential causative agent of zygomycosis.
一名22岁的日本女性被诊断为噬血细胞性淋巴组织细胞增生症，随后接受了依托泊苷和环磷酰胺治疗。在第22天，双侧肺部出现多个结节性病变。所使用的抗生素和抗真菌药物均无效，她在第35天突然死于呼吸衰竭。尸检显示播散性接合菌病和由于血管侵袭性真菌栓塞导致的肺梗死，后来通过18S rRNA原位杂交鉴定该真菌为拜氏 Cunninghamella。拜氏 Cunninghamella具有侵袭性且对抗真菌药物耐药。因此，这种罕见的菌种应被视为接合菌病的潜在病原体。
