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在一名肺结核患者中,由单孢瓶霉引起的着色芽生菌病被误诊为孢子丝菌病和皮肤结核。

Chromoblastomycosis due to Fonsecaea monophora misdiagnosed as sporotrichosis and cutaneous tuberculosis in a pulmonary tuberculosis patient.

作者信息

Shi Dongmei, Zhang Wei, Lu Guixia, de Hoog G Sybren, Liang Guanzhao, Mei Huan, Zheng Hailin, Shen Yongnian, Liu Weida

机构信息

Department of Dermatology, Jining No. 1 People's Hospital, Shandong, PR China; Department of Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, PR China.

Department of Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, PR China.

出版信息

Med Mycol Case Rep. 2016 May 10;11:57-60. doi: 10.1016/j.mmcr.2016.05.001. eCollection 2016 Mar.

Abstract

Chromoblastomycosis is caused by dematiaceous fungi. It develops after inoculation of the organism into the skin. We report a case of chromoblastomycosis in a pulmonary tuberculosis patient without known history of trauma. The lesions were initially diagnosed as sporotrichosis and skin tuberculosis. Histopathology of scales and skin biopsy specimen revealed sclerotic bodies, the hallmark of chromoblastomycosis. The causative organism was identified as Fonsecaea monophora by rDNA ITS sequencing. The lesions recovered markedly after two month treatment with oral terbinafine 250 mg daily according to drug sensitive test in vitro in combination with local thermotherapy.

摘要

着色芽生菌病由暗色真菌引起。该菌接种入皮肤后发病。我们报告一例无已知创伤史的肺结核患者发生着色芽生菌病的病例。病变最初被诊断为孢子丝菌病和皮肤结核。鳞屑和皮肤活检标本的组织病理学检查发现了硬化小体,这是着色芽生菌病的标志。通过rDNA ITS测序,确定致病病原体为单孢瓶霉。根据体外药敏试验,患者每日口服250毫克特比萘芬并结合局部热疗,治疗两个月后病变明显好转。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ef3/4907037/fc490f662074/gr1.jpg

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