Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Department of Dermatology and Allergy, Technische Universität München, Munich, Germany.
Mycoses. 2016 Dec;59(12):818-821. doi: 10.1111/myc.12540. Epub 2016 Sep 7.
Superficial candida infections of the skin are common, but deep cutaneous candidiasis, including secondary dissemination to the skin from systemic candidiasis, candidaemia or primary invasion due to skin defects such as trauma, is rare. These patients are usually immunosuppressed, but immunocompetent hosts can be affected as well. Candida albicans is the most common pathogen. However, non-albicans Candida species can cause deep skin invasion in rare circumstances. We report a case of deep cutaneous candidiasis caused by Candida duobushaemulonii in a 68-year-old man. Deep tissue invasion was confirmed by skin histopathology examination. The pathogen was initially identified as C. haemulonii using the VITEK 2 system for microbial identification, but was later determined to be C. duobushaemulonii based on sequencing of the internal transcribed spacer region of ribosomal DNA and D1/D2 region of 26S rDNA. The patient was successfully treated with amphotericin B, followed by fluconazole and surgical intervention. To the best of our knowledge, this is the first case of deep cutaneous infection by C. duobushaemulonii.
皮肤浅部念珠菌感染很常见，但深部皮肤念珠菌病，包括系统性念珠菌病、念珠菌血症或因创伤等皮肤缺陷引起的原发性侵袭引起的皮肤继发性播散，较为罕见。这些患者通常存在免疫抑制，但免疫功能正常的宿主也可能受到影响。白色念珠菌是最常见的病原体。然而，在罕见情况下，非白念珠菌属念珠菌也可引起深部皮肤侵袭。我们报告了一例由双头假丝酵母菌引起的 68 岁男性深部皮肤念珠菌病。皮肤组织病理学检查证实存在深部组织侵袭。最初使用 VITEK 2 系统进行微生物鉴定，将病原体鉴定为 C. haemulonii，但后来根据核糖体 DNA 的内部转录间隔区和 26S rDNA 的 D1/D2 区测序，确定为 C. duobushaemulonii。该患者经两性霉素 B 治疗后，成功转为氟康唑治疗，并进行了手术干预。据我们所知，这是首例由 C. duobushaemulonii 引起的深部皮肤感染。
