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播散性组织胞浆菌病和抗合成酶综合征患者的组织胞浆菌性脓性肌炎:基于病例的文献综述

Histoplasma Pyomyositis in a Patient with Disseminated Histoplasmosis and Anti-Synthetase Syndrome: Case-Based Review of Literature.

作者信息

Nair Harikrishnan Gangadharan, Aggarwal Amita, Naveen R, Marak Rungmei Sk, Agarwal Rachna, Gupta Latika

机构信息

Departments of Clinical Immunology and Rheumatology.

Microbiology and.

出版信息

Mediterr J Rheumatol. 2020 Sep 30;31(3):350-354. doi: 10.31138/mjr.31.3.350. eCollection 2020 Sep.

DOI:10.31138/mjr.31.3.350
PMID:33163869
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7641030/
Abstract

BACKGROUND

Histoplasmosis is an endemic mycosis caused by Histoplasma Capsulatum, a thermally dimorphic fungus with mycelial and yeast forms. Muscle involvement is infrequent in Histoplasmosis.

CASE

A 49-year-old lady presented with generalized myalgia and arthritis of two-year duration, which had responded partly to glucocorticoids. The lady reported to us two years into the illness with ulcerative eyelid lesions, worsening myalgia, and painful skin nodules. Eventually, it turned out that anti-synthetase syndrome was the primary diagnosis with Histoplasma infection in the muscles, subcutaneous tissue, and eye. We herewith present the course of her illness and a review of Histoplasmosis of the muscle in literature.

CONCLUSION

The differential diagnosis of painful muscle weakness is broad. Histoplasma capsulatum infection should be considered in immunosuppressed myositis patient presenting with orbital ulcers, skin nodules and worsening muscle weakness.

摘要

背景

组织胞浆菌病是由荚膜组织胞浆菌引起的一种地方性真菌病,荚膜组织胞浆菌是一种具有菌丝体和酵母形式的双相真菌。组织胞浆菌病很少累及肌肉。

病例

一名49岁女性,出现持续两年的全身肌痛和关节炎,对糖皮质激素治疗有部分反应。该患者在患病两年后来我院就诊,伴有溃疡性眼睑病变、肌痛加重和疼痛性皮肤结节。最终,诊断为抗合成酶综合征,同时肌肉、皮下组织和眼部存在组织胞浆菌感染。我们在此介绍她的病程,并对文献中有关肌肉组织胞浆菌病进行综述。

结论

疼痛性肌无力的鉴别诊断范围广泛。对于出现眼眶溃疡、皮肤结节和肌无力加重的免疫抑制性肌炎患者,应考虑荚膜组织胞浆菌感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08a5/7641030/105da51eed63/MJR-31-3-350-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08a5/7641030/3f54f82cafc4/MJR-31-3-350-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08a5/7641030/60483d54e6f4/MJR-31-3-350-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08a5/7641030/105da51eed63/MJR-31-3-350-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08a5/7641030/3f54f82cafc4/MJR-31-3-350-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08a5/7641030/60483d54e6f4/MJR-31-3-350-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08a5/7641030/105da51eed63/MJR-31-3-350-g003.jpg

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本文引用的文献

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Skin Lesions and Multifocal Myositis in a Patient With Rheumatoid Arthritis.
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Histoplasmosis Myocarditis in an Immunocompetent Host After a Recreational Mud Run.免疫功能正常宿主在参加泥地趣味赛跑后发生组织胞浆菌性心肌炎。
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Laboratory Diagnostics for Histoplasmosis.组织胞浆菌病的实验室诊断
J Clin Microbiol. 2017 Jun;55(6):1612-1620. doi: 10.1128/JCM.02430-16. Epub 2017 Mar 8.
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Tuberculous Fasciitis in Polymyositis: A Rare Case of Extrapulmonary Tuberculosis.多发性肌炎合并结核性筋膜炎:一例罕见的肺外结核病例
Intern Med. 2016;55(21):3205-3209. doi: 10.2169/internalmedicine.55.5548. Epub 2016 Nov 1.
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Clinical Spectrum Time Course in Anti Jo-1 Positive Antisynthetase Syndrome: Results From an International Retrospective Multicenter Study.抗 Jo-1 阳性抗合成酶综合征的临床谱随时间变化:一项国际回顾性多中心研究的结果
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