Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
J Infect Chemother. 2019 Dec;25(12):1031-1036. doi: 10.1016/j.jiac.2019.05.002. Epub 2019 Jun 20.
Chromoblastomycosis (CBM) is a chronic cutaneous and subcutaneous fungal infection caused by certain dematiaceous fungi (usually Fonsecaea, Phialophora, or Cladophialophora). Histologically, CBM is characterized by the presence of medlar bodies. However, the diagnosis is difficult because of the rarity of these pathognomonic presentations and the wide variety of presentations. Treatment of these infections is challenging as it lacks standardization. Herein, we report a case of chromoblastomycosis caused by Phialophora, in a 42-year-old immunocompetent male agriculturist from the humid and subtropical region of southern China. He had a 3-month history of pneumonia with intermittent fever, coughing, and expectoration. The infection subsequently spread to the bone and lymph nodes forming deep lesions and eventually resulting in osteolysis and lymphadenectasis. These subcutaneous nodules were observed after 9 months. Antifungal treatment was administered for 20 months leading to clinical improvement before the patient was lost to follow-up. This case is unique because such deep lesions are rare in immunocompetent individuals and because the initial onset was associated with pneumonia.
着色芽生菌病（CBM）是一种由某些暗色真菌（通常是镰孢菌、帚霉属或枝孢霉属）引起的慢性皮肤和皮下真菌感染。组织学上，CBM 的特征是存在杨梅体。然而，由于这些特征性表现的罕见性和广泛的表现形式，诊断具有挑战性。由于缺乏标准化，这些感染的治疗具有挑战性。在此，我们报告了一例由中国南方湿润亚热带地区的一名 42 岁免疫功能正常的男性农民引起的帚霉属着色芽生菌病。他患有肺炎，有 3 个月的间歇性发热、咳嗽和咳痰病史。感染随后扩散到骨骼和淋巴结，形成深部病变，最终导致骨质溶解和淋巴结肿大。9 个月后观察到这些皮下结节。给予抗真菌治疗 20 个月，在患者失访前临床症状改善。该病例的独特之处在于，免疫功能正常的个体中如此深部病变较为罕见，并且初始发病与肺炎有关。
