Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China,
Mycopathologia. 2014 Aug;178(1-2):129-33. doi: 10.1007/s11046-014-9770-4. Epub 2014 Jun 20.
We report a case of primary cutaneous mucormycosis caused by Mucor irregularis. A 47-year-old farmer was presented to our clinic with the history of progressive red plaque around the inner canthus following dacryocystectomy about a year earlier. Linear, aseptate hyphae were seen by direct KOH examination and in biopsy. Fungal culture revealed light yellow filamentous colonies that were identified as Mucor irregularis by nucleotide sequencing of rRNA gene. Amphotericin B and dexamethasone were used in gradually increasing dosage. The treatment lasted 43 days, and the patient received 760 mg total amphotericin B. The patient was discharged after 2 months of treatment. The plaque became smooth, and fungal culture was negative. There was no recurrence for half a year through telephone follow-ups. A review of published studies revealed 23 cases of Mucor irregularis infection. Most cases resulted following injuries or surgical complications. Farmers and manual laborers were most at risk with males outnumbering females among patients. Amphotericin B and its liposomal preparations remain most effective treatment choices.
我们报告一例由不规则毛霉引起的原发性皮肤毛霉病。一位 47 岁的农民因一年前泪囊切除术后在内眼角周围出现进行性红斑斑块而就诊于我院。直接 KOH 检查和活检均可见线性、无隔菌丝。真菌培养显示出浅黄色丝状菌落,通过 rRNA 基因的核苷酸测序鉴定为不规则毛霉。两性霉素 B 和地塞米松逐渐增加剂量使用。治疗持续 43 天,患者接受了 760 毫克总两性霉素 B。经过 2 个月的治疗,患者出院。斑块变得光滑,真菌培养阴性。通过电话随访半年内无复发。对已发表研究的回顾显示,有 23 例不规则毛霉感染病例。大多数病例是在受伤或手术后并发症后发生的。农民和体力劳动者风险最高,患者中男性多于女性。两性霉素 B 及其脂质体制剂仍然是最有效的治疗选择。