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皮下蛙粪霉病:一例报告

Subcutaneous basidiobolomycosis: A Case Report.

作者信息

Sackey Adziri, Ghartey Nenyin, Gyasi Richard

机构信息

Department of Child Health, School of Medicine and Dentistry, College of Health Sciences, P.O. Box 4236, Accra, Ghana.

Children's Block, Korle Bu Teaching Hospital, P.O. Box 77, Korle Bu, Accra.

出版信息

Ghana Med J. 2017 Mar;51(1):43-46. doi: 10.4314/gmj.v51i1.9.

Abstract

UNLABELLED

Basidiobolomycosis is an uncommon chronic deep fungal infection in which gradually enlarging granulomas form, usually in the subcutaneous fat tissues of the limbs, chest or trunk of immunocompetent hosts, primarily children and young adults. It is caused by the fungus . Definitive diagnosis is by microscopy and histopathology. Effective treatments include ketoconazole, itraconazole, potassium iodide and co-trimoxazole. A 3 year old girl presented with ulcerations on the right thigh for one month, and painful swelling of the right leg and right buttock for six months. The right lower limb and vulva were swollen, tender and hard with hyperpigmentation and inguinal lymphadenopathy. She had severe anaemia, eosinophilia and negative serology for HIV I and II. Histopathological examination showed a dermal chronic granulomatous infiltrate with fungal hyphae and yeast forms suggestive of Basidiobolus ranarum. There was marked reduction in right leg size and inguinal lymphadenopathy after several weeks of oral itraconazole, and complete healing of ulcers after 10 weeks. The purpose of this report is to increase awareness of this disfiguring condition which is treatable but, if not correctly diagnosed, could result in inappropriate interventions such as amputation and anti-coagulant therapy.

FUNDING

None declared.

摘要

未标注

蛙粪霉病是一种罕见的慢性深部真菌感染,通常在免疫功能正常的宿主(主要是儿童和年轻人)的四肢、胸部或躯干的皮下脂肪组织中形成逐渐增大的肉芽肿。它由真菌引起。确诊依靠显微镜检查和组织病理学检查。有效的治疗方法包括酮康唑、伊曲康唑、碘化钾和复方新诺明。一名3岁女童右大腿溃疡1个月,右腿和右臀部疼痛性肿胀6个月。右下肢和外阴肿胀、压痛、变硬,伴有色素沉着和腹股沟淋巴结肿大。她患有严重贫血、嗜酸性粒细胞增多,HIV I和II血清学检查阴性。组织病理学检查显示真皮慢性肉芽肿浸润,伴有真菌菌丝和酵母样形态,提示为蛙粪霉。口服伊曲康唑数周后,右腿尺寸和腹股沟淋巴结肿大明显减轻,10周后溃疡完全愈合。本报告的目的是提高对这种毁容性疾病的认识,该病可治疗,但如果诊断不正确,可能导致不适当的干预措施,如截肢和抗凝治疗。

资金来源

未声明。

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本文引用的文献

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A case of subcutaneous zygomycosis.一例皮下毛霉病。
Indian Dermatol Online J. 2014 Jan;5(1):51-4. doi: 10.4103/2229-5178.126033.
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Severe cutaneous zygomycosis due to Basidiobolus ranarum in a young infant.一名幼儿因蛙粪霉引起的严重皮肤接合菌病。
Pediatr Dermatol. 2012 Jan-Feb;29(1):121-3. doi: 10.1111/j.1525-1470.2011.01476.x. Epub 2011 Sep 9.
9
A review of zygomycosis due to Basidiobolus ranarum.由蛙粪霉引起的接合菌病综述。
Eur J Epidemiol. 1999 Nov;15(10):923-9. doi: 10.1023/a:1007656818038.
10
Basidiobolomycosis in Ghanaian children.
Trop Doct. 1994 Oct;24(4):170-1. doi: 10.1177/004947559402400410.

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