Kakeya Hiroshi, Izumikawa Koichi, Yamada Koichi, Narita Yusuke, Nishino Tomoya, Obata Yoko, Takazono Takahiro, Kurihara Shintaro, Kosai Kosuke, Morinaga Yoshitomo, Nakamura Shigeki, Imamura Yoshifumi, Miyazaki Taiga, Tsukamoto Misuzu, Yanagihara Katsunori, Takenaka Motoi, Tashiro Takayoshi, Kohno Shigeru
Department of Infection Control Science, Graduate School of Medicine, Osaka City University, Japan.
Intern Med. 2014;53(12):1385-90. doi: 10.2169/internalmedicine.53.1409. Epub 2014 Jun 15.
A 50-year-old man with a history of long-term corticosteroid treatment following adrenalectomy for Cushing's syndrome and uncontrolled diabetes mellitus was admitted for an examination of an abnormal thoracic shadow. Cryptococcal serum antigens were positive, and the histopathology of a lung biopsy showed encapsulated yeast resembling Cryptococcus neoformans. On admission, the serum β-D-glucan level was approximately twice the cutoff value, several nodules were observed on both legs and magnetic resonance imaging revealed subcutaneous abscesses. Candida albicans was identified from needle aspirates, and the patient was successfully treated with fluconazole and flucytosine. We herein report the first case of concurrent C. albicans skin abscesses and pulmonary cryptococcosis.
一名50岁男性，因库欣综合征行肾上腺切除术后长期接受皮质类固醇治疗，患有未控制的糖尿病，因检查胸部异常阴影入院。隐球菌血清抗原呈阳性，肺活检的组织病理学显示有类似新型隐球菌的包膜酵母。入院时，血清β - D - 葡聚糖水平约为临界值的两倍，双下肢观察到多个结节，磁共振成像显示皮下脓肿。从针吸物中鉴定出白色念珠菌，患者接受氟康唑和氟胞嘧啶治疗成功。我们在此报告首例白色念珠菌皮肤脓肿并发肺隐球菌病的病例。
