黄曲霉引起的肋骨骨髓炎
Osteomyelitis of the rib cage by Aspergillus flavus.
作者信息
Landaburu María Fernanda, López Daneri Gabriela, Ploszaj Federico, Kruss Mariana, Vinante Alejandra, Veciño Cecilia H, Mujica María Teresa
机构信息
Centro de Micología, Departamento de Microbiología, Parasitología e Inmunología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina; Sanatorio Municipal Dr. Julio Méndez, Buenos Aires, Argentina.
Centro de Micología, Departamento de Microbiología, Parasitología e Inmunología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina.
出版信息
Rev Iberoam Micol. 2019 Apr-Jun;36(2):86-89. doi: 10.1016/j.riam.2019.02.002. Epub 2019 May 22.
BACKGROUND
Aspergillus osteomyelitis of the ribs is relatively uncommon. It is a debilitating and severe form of invasive aspergillosis.
CASE REPORT
A 61year-old female presented with spontaneous chest pain on the right side of the rib cage and a palpable soft-tissue mass. FDG-PET/CT scan identified activity in the infected site. The lesion was punctured, and purulent material was sent to the laboratory. Aspergillus complex Flavi was isolated. An antifungal treatment with voriconazole was started. The lesion healed, and no recurrence was observed at 8-month follow-up. Molecular identification of the isolate was based on PCR amplification and sequencing of β-tubulin gene. Aspergillus flavus was identified.
CONCLUSIONS
Our case highlights the relevance of microbiological studies in patients with osteomyelitis and the involvement of soft tissue. The FDG-PET/CT scan was found to be a useful tool for revealing the extent of the disease and evaluating the response to the antifungal therapy.
背景
肋骨曲霉菌骨髓炎相对少见。它是侵袭性曲霉菌病的一种使人衰弱的严重形式。
病例报告
一名61岁女性，出现右胸廓自发性胸痛，可触及软组织肿块。FDG-PET/CT扫描显示感染部位有活性。对病变进行穿刺，将脓性物质送检。分离出黄曲霉复合群。开始用伏立康唑进行抗真菌治疗。病变愈合，8个月随访未观察到复发。分离株的分子鉴定基于β-微管蛋白基因的PCR扩增和测序。鉴定为黄曲霉。
结论
我们的病例突出了骨髓炎患者微生物学研究的相关性以及软组织受累情况。发现FDG-PET/CT扫描是揭示疾病范围和评估抗真菌治疗反应的有用工具。
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