Departments of Medicine and Pediatrics, The Immunology Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1089, New York, NY, 10029, USA.
J Clin Immunol. 2014 Feb;34(2):130-3. doi: 10.1007/s10875-013-9967-1. Epub 2013 Dec 6.
Chronic Granulomatous Disease (CGD), caused by genetic defects in components of the phagocyte NADPH oxidase pathway, leads to recurrent life-threatening bacterial and invasive fungal infections. While a number of unique pathogens have been associated with this disease, the causative organisms may be difficult to identify. Here, we present a 24 year old male with known X-linked CGD who concurrently developed a cervical abscess and an abscess in the subcutaneous tissues of the right hip, both of which were surgically drained. Cultures failed to identify any organisms. He was treated empirically with ertapenem but the hip abscess recurred at the original site and in contiguous dependent areas in the posterior thigh and knee. A filamentous organism was observed microscopically, initially considered a contaminant, but on culture yielded a mold growth, identified as Phellinus tropicalis (synonym: Inonotus tropicalis) based on phenotypic and molecular methods. This is the third case report of human infection with P. tropicalis, all in subjects with CGD. The patient was treated with voriconazole with resolution of his symptoms.
慢性肉芽肿病（CGD）是由于吞噬细胞 NADPH 氧化酶途径中成分的遗传缺陷引起的，导致反复发生危及生命的细菌性和侵袭性真菌感染。虽然已经确定了一些与这种疾病相关的独特病原体，但致病生物可能难以识别。在这里，我们介绍了一名 24 岁的男性，他患有已知的 X 连锁 CGD，同时发生了颈部脓肿和右臀部皮下组织脓肿，均进行了手术引流。培养未能鉴定出任何病原体。他经验性地接受了厄他培南治疗，但髋关节脓肿在原部位和后大腿和膝盖的相邻依赖区域复发。显微镜下观察到一种丝状生物，最初被认为是污染物，但在培养中产生了一种霉菌生长，根据表型和分子方法鉴定为热带灵芝（同义词：热带多孔菌）。这是第三例人类感染热带灵芝的病例报告，均发生在 CGD 患者中。该患者接受伏立康唑治疗，症状缓解。
