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一名患有乔布氏(高免疫球蛋白E)综合征患者的皮肤镰刀菌病。

Cutaneous Fusariosis in a Patient with Job's (Hyper-IgE) Syndrome.

作者信息

Altibi Ahmed M, Sheth Radhika, Battisha Ayman, Kak Vivek

机构信息

Henry Ford Allegiance Health (HFAH), Jackson, MI, USA.

Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, USA.

出版信息

Case Rep Infect Dis. 2020 Jun 15;2020:3091806. doi: 10.1155/2020/3091806. eCollection 2020.

Abstract

is a filamentous fungus that is ubiquitous in nature and can cause severe opportunistic infections in immunocompromised hosts. The association between and hyper-IgE syndrome is exceedingly rare and has only been documented in a single report previously. A 44-year-old male, working as marijuana grower, with prior diagnosis of hyper-IgE syndrome and recurrent infections presented with enlarging right knee ulcer that did not respond to antimicrobial treatment. The patient was diagnosed with cutaneous fusariosis, confirmed with punch biopsy and positive wound cultures. The patient was managed with extended antifungal therapy (i.e., posaconazole) and surgical debridement resulting in remarkable improvement with wound healing leaving a pale scar. should be considered in differential for cutaneous and invasive fungal infections in presence of cutaneous manifestations. Exposure to plants is a noticeable risk factor. Multimodal approach involving systemic antifungals and wound debridement is essential for favorable outcome. Posaconazole was demonstrated to be a highly efficacious antifungal choice.

摘要

是一种丝状真菌,在自然界中普遍存在,可在免疫功能低下的宿主中引起严重的机会性感染。与高IgE综合征之间的关联极为罕见,此前仅在一份报告中有记载。一名44岁男性,职业为大麻种植者,既往诊断为高IgE综合征且反复感染,现出现右膝溃疡增大,对抗菌治疗无反应。患者被诊断为皮肤镰刀菌病,经穿刺活检和伤口培养阳性确诊。患者接受了延长的抗真菌治疗(即泊沙康唑)和手术清创,伤口愈合显著改善,留下淡疤。在存在皮肤表现的情况下,对于皮肤和侵袭性真菌感染的鉴别诊断应考虑到。接触植物是一个明显的危险因素。涉及全身抗真菌药物和伤口清创的多模式方法对于取得良好结果至关重要。泊沙康唑被证明是一种高效的抗真菌选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70ed/7315260/c8ef1966f697/CRIID2020-3091806.001.jpg

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