Beltrame Anna, Danesi Patrizia, Farina Claudio, Orza Pierantonio, Perandin Francesca, Zanardello Claudia, Rodari Paola, Staffolani Silvia, Bisoffi Zeno
Centre for Tropical Diseases, Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy.
Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy.
Am J Trop Med Hyg. 2017 Dec;97(6):1757-1760. doi: 10.4269/ajtmh.17-0446. Epub 2017 Sep 21.
Lobomycosis is a chronic skin mycosis endemic in Amazon regions characterized by chronic nodular or keloidal lesions caused by , an uncultivable fungus. Imported cases in nonendemic countries are rare and diagnosed after years. We describe a case of lobomycosis in a healthy 55-year-old Italian traveler who had acquired the infection during 5-day-honeymoon in the Amazon region of Venezuela in 1999. Several weeks after return, he recalled pruritus and papular skin lesions on the left lower limb, subsequently evolving to a plaque-like lesion. Blastomycosis and cryptococcosis were hypothesized based on microscopic morphology of yeast-like bodies found in three consecutive biopsies, although fungal cultures were always negative. In 2016, exfoliative cytology and a biopsy specimen examination showed round yeast-like organisms (6-12 μm), isolated or in a chain, connected by short tubular projections fulfilling the morphologic diagnostic criteria of spp. The microscopic diagnosis was confirmed by molecular identification.
芽生菌病是一种在亚马逊地区流行的慢性皮肤真菌病，其特征为由一种不可培养的真菌引起的慢性结节性或瘢痕疙瘩样病变。非流行国家的输入性病例罕见，且数年后才能确诊。我们描述了一例芽生菌病病例，患者为一名55岁健康的意大利旅行者，他于1999年在委内瑞拉的亚马逊地区度5天蜜月期间感染此病。回国几周后，他回忆起左下肢有瘙痒和丘疹性皮肤病变，随后发展为斑块样病变。根据连续三次活检中发现的酵母样体的微观形态，推测为芽生菌病和隐球菌病，尽管真菌培养始终为阴性。2016年，脱落细胞学检查和活检标本检查显示圆形酵母样生物体（6 - 12μm），单个或成链状，通过短管状突起相连，符合芽生菌属的形态学诊断标准。通过分子鉴定证实了微观诊断。
