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肺包虫囊肿与曲霉菌球合并存在:一种罕见的混合感染。

Concomitant of Pulmonary Hydatid Cyst and Aspergilloma: A Rare Coinfection.

作者信息

Zareshahrabadi Zahra, Sarkari Bahador, Shamsolvaezin Nadereh, Ziaian Bizhan, Tootoonchi Alireza, Shahriarirad Reza, Zomorodian Kamiar

机构信息

Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Kowsar Hospitals, Shiraz, Iran.

出版信息

Case Rep Infect Dis. 2020 Dec 12;2020:6650478. doi: 10.1155/2020/6650478. eCollection 2020.

Abstract

The coexistence of cystic echinococcosis (CE) and aspergilloma is rather uncommon. species, saprophytic fungi, can colonize pulmonary cavities that are caused by tuberculosis, sarcoidosis, and CE. Infection by is often occurring in immunosuppressed patients. However, coinfection of aspergilloma with pulmonary hydatid cyst is very unusual, especially in an immunocompetent patient with unruptured cyst. Herein, we report a case of lung hydatid cyst coinfected with in a 42-year-old Iranian man from Southern Iran. Chest X-ray and computed tomography (CT) scan showed a circumscribed cystic lesion in the superior and inferior segment of the lower lobes of right and left lungs that suggests hydatid cyst. Radical surgery (lobectomy) was performed for the patient. Histopathological evaluation reconfirmed the classical laminated layer of hydatid cyst. Moreover, the ectocyst layer of the right lung showed the presence of numerous cluster septate hyphae with acute-angled branching, as seen in the morphology of species. DNA was extracted from the cyst, and the ITS1-5.8s-ITS2 region of the fungal agent was amplified. Sequencing and analysis of seminested PCR product revealed that the isolate has the most similarity with . Further attention is recommended to control fungal pathogens during pulmonary hydatidosis. The coexistence of aspergilloma should always be kept in mind for the better management of CE.

摘要

囊型包虫病(CE)与曲菌球并存相当罕见。曲霉菌属腐生真菌,可寄生于由肺结核、结节病和囊型包虫病所致的肺空洞内。曲霉菌感染常见于免疫抑制患者。然而,曲菌球与肺包虫囊肿合并感染非常罕见,尤其是在免疫功能正常且囊肿未破裂的患者中。在此,我们报告一例来自伊朗南部的42岁伊朗男性,其肺包虫囊肿合并曲霉菌感染。胸部X线和计算机断层扫描(CT)显示左右肺下叶上下段有一个边界清晰的囊性病变,提示为包虫囊肿。对该患者实施了根治性手术(肺叶切除术)。组织病理学评估再次证实了包虫囊肿的典型板层结构。此外,右肺的外囊层可见大量成簇的分隔菌丝,呈锐角分支,这与曲霉菌属的形态特征相符。从囊肿中提取了DNA,并扩增了真菌病原体的ITS1-5.8s-ITS2区域。半巢式PCR产物的测序和分析显示,分离株与曲霉菌属最为相似。建议在肺包虫病治疗过程中进一步关注控制真菌病原体。为更好地管理囊型包虫病,应始终牢记曲菌球并存的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6ae/7787855/7937a0f9498d/CRIID2020-6650478.001.jpg

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