Department of Microbiology, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, Delhi 110095, India.
Department of Dermatology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi 110095, India.
J Mycol Med. 2017 Dec;27(4):577-581. doi: 10.1016/j.mycmed.2017.09.004. Epub 2017 Nov 6.
Identification of dematiaceous fungi responsible for black-grain mycetoma has remained cumbersome and time consuming for years leading to delayed diagnosis and thereby increased agony to patients. Moreover, difficult morphology of some of these fungi demanding enough expertise for species identification in addition to culture-negativity has often led to misdiagnosis and hence inapt treatment to the patients. We report the identification of Madurella mycetomatis from culture-negative black granules discharged from foot nodular lesions of a 27 years old male using PCR followed by sequencing of the internal transcribed spacer region. The patient's lesions were successfully treated using a combination of itraconazole (200mg) and terbinafine (250mg), confirming our diagnosis. Our case study proves the clinical value of PCR as the best, rapid and accurate diagnostic method for the identification of Madurella mycetomatis and related fungi, particularly in culture-negative cases.
多年来，鉴定导致黑曲霉病的暗色真菌一直很繁琐和耗时，导致诊断延误，从而给患者带来更多痛苦。此外，由于一些真菌的形态学较为复杂，除了培养阴性外，还需要足够的专业知识来进行物种鉴定，这常常导致误诊，从而给患者带来不适当的治疗。我们使用 PCR 技术，结合测序内部转录间隔区，从一名 27 岁男性足部结节病变排出的培养阴性黑颗粒中鉴定出了枝顶孢霉。该患者的病变成功地采用伊曲康唑（200mg）和特比萘芬（250mg）联合治疗，证实了我们的诊断。我们的病例研究证明了 PCR 作为一种最佳、快速和准确的诊断方法，用于鉴定枝顶孢霉和相关真菌，特别是在培养阴性的情况下。
