Department of Dermatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, No. 158, Shangtang Road, Hangzhou, 310014, Zhejiang, China.
Emergency Room, Shanghai Tenth People's Hospital of Tongji University, Shanghai, China.
Mycopathologia. 2018 Apr;183(2):417-421. doi: 10.1007/s11046-017-0228-3. Epub 2017 Nov 22.
The incidence of candidiasis due to non-albicans Candida species (especially Candida glabrata) has significantly increased in recent decades. Candida glabrata often invades immunocompromised hosts and causes systemic or mucosal infections, whereas cutaneous infections are rarely reported. We present a rare case of cutaneous infection caused by C. glabrata and review all similar cases available in the PubMed database. A patient was admitted to the hospital with a 2-month history of a plaque on the face. Histopathological examination displayed typical infectious granulomas in the deep dermis, and the pathogen was finally confirmed as C. glabrata using a series of microbial examinations (fungal culture, biochemical test, and PCR-directed sequencing). The patient was completely cured after 4 months of treatment with oral itraconazole combined with topical terbinafine. We reviewed similar reports of cutaneous infection caused by C. glabrata. All the data suggested that an accurate diagnosis of cutaneous candidiasis depends mainly on histological and fungal examinations, especially molecular biological assays. Antifungal agents based on microbial susceptibility tests are the first-line treatment choice for C. glabrata infection, but the prognosis might be more dependent on the basic condition of the host.
近年来,非白念珠菌属(尤其是近平滑念珠菌)所致念珠菌病的发病率显著增加。近平滑念珠菌常侵袭免疫功能低下的宿主,引起全身或黏膜感染,而皮肤感染则很少见。我们报告了一例由近平滑念珠菌引起的罕见皮肤感染病例,并回顾了 PubMed 数据库中所有类似病例。一名患者因面部斑块就诊,病史 2 个月。组织病理学检查显示真皮深部有典型的感染性肉芽肿,经一系列微生物检查(真菌培养、生化试验和 PCR 定向测序)最终确诊为近平滑念珠菌。该患者经 4 个月的伊曲康唑口服联合特比萘芬外用治疗后痊愈。我们回顾了由近平滑念珠菌引起的皮肤感染的类似报告。所有数据均表明,准确诊断皮肤念珠菌病主要依赖于组织学和真菌学检查,尤其是分子生物学检测。基于微生物药敏试验的抗真菌药物是治疗近平滑念珠菌感染的首选药物,但预后可能更多地取决于宿主的基本状况。