Kuo T T, Hseuh S, Wu J L, Wang A M
Arch Pathol Lab Med. 1987 Aug;111(8):737-40.
In what we believe to be the first case of cutaneous protothecosis identified in Taiwan, a 5-year-old Chinese girl presented with a pruritic erythematous plaque on her right upper eyelid. A clinical diagnosis of eczematous dermatitis was made initially, and sporotrichosis was diagnosed subsequently. Later, histopathologic and cultural studies of the lesion finally led to the diagnosis of protothecosis. The recognition of the characteristic sporangia containing symmetrically arranged endospores is the most important initial diagnostic clue of protothecosis. Biochemical assimilation tests and direct immunofluorescence study using species-specific antibodies identified the organism as Prototheca wickerhamii. Systemic ketoconazole treatment proved to be effective for our patient. The in vitro minimal inhibitory concentrations of tetracycline hydrochloride, amphotericin B, and ketoconazole were also determined.
我们认为这是台湾首例确诊的皮肤原藻病病例，一名5岁中国女童右上眼睑出现瘙痒性红斑斑块。最初临床诊断为湿疹性皮炎，随后诊断为孢子丝菌病。后来，对该病变进行组织病理学和培养研究，最终确诊为原藻病。识别含有对称排列内生孢子的特征性孢子囊是原藻病最重要的初步诊断线索。生化同化试验和使用种特异性抗体的直接免疫荧光研究确定该病原体为威克海姆原藻。全身酮康唑治疗对我们的患者有效。还测定了盐酸四环素、两性霉素B和酮康唑的体外最低抑菌浓度。
