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多哥的担子菌病:12例疑似病例的临床病理研究

Basidiobolomycosis in Togo: clinico-pathological study of a series of 12 presumed cases.

作者信息

Darré Tchin, Saka Bayaki, Mouhari-Toure Abas, Djiwa Toukilnan, Pitché Palokinam, Napo-Koura Gado

机构信息

Department of Pathology, University Teaching Hospital of Lomé, Lomé, Togo.

University of Lomé, BP 1515, Lomé, Togo.

出版信息

BMC Res Notes. 2018 Sep 14;11(1):667. doi: 10.1186/s13104-018-3777-8.

Abstract

OBJECTIVE

The purpose of our study was to describe the histological diagnosed of the Basidiobolomycosis cases from 1990 to 2017 (28 years) in the only Pathology Anatomy Laboratory in Togo.

RESULTS

A total of 12 cases of suspected Basidiobolomycosis have been identified. The sex ratio (M/F) was 2. The average age of the patients was 24.8 ± 1.6 years. Six patients (6/12) had a pathological history: HIV infection (n = 4 cases) and tuberculosis (n = 2 cases). The clinical manifestations were localized to pure skin (n = 9 cases), skin and mucous digestive (n = 2 cases) and disseminated (n = 1 cases). Direct mycological examination and culture in 4 patients was positive in 3 patients. The samples examined consisted of 11 cutaneous biopsies measuring 1-3 cm and a biopsy of the intestinal mucosa. Histology showed granulomatous inflammation of the dermohypodermal site with numerous giant cells associated with eosinophilic polynuclear cells, in which there are 5-7 mm non-septate, irregular mycelial filaments. Patients were treated with ketoconazole at a dose of 10 mg/kg daily. The progression of the patients' condition was favorable after 4 weeks of treatment with a regression of the closets size. Patients were completely healed after 8 weeks of treatment, without recurrence after 6 months. No deaths have been recorded.

摘要

目的

我们研究的目的是描述1990年至2017年(28年)在多哥唯一的病理解剖实验室中经组织学诊断的担子菌病病例。

结果

共鉴定出12例疑似担子菌病病例。男女比例(男/女)为2。患者的平均年龄为24.8±1.6岁。6例患者(6/12)有病史:艾滋病毒感染(n = 4例)和结核病(n = 2例)。临床表现局限于单纯皮肤(n = 9例)、皮肤和消化道黏膜(n = 2例)以及播散性(n = 1例)。4例患者的直接真菌学检查和培养中,3例呈阳性。所检查的样本包括11块1 - 3厘米的皮肤活检组织和1块肠黏膜活检组织。组织学显示真皮皮下部位有肉芽肿性炎症,有大量与嗜酸性多核细胞相关的巨细胞,其中有5 - 7毫米无隔、不规则的菌丝丝。患者接受酮康唑治疗,剂量为每日10毫克/千克。治疗4周后患者病情进展良好,病灶大小有所缩小。治疗8周后患者完全康复,6个月后无复发。未记录到死亡病例。

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