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膝关节骨关节孢子丝菌病:两例相似病例,结局不同

Osteoarticular Sporotrichosis of the Knee Caused by : Two Similar Cases with Different Outcomes.

作者信息

de Sousa Bruno Ivanovinsky Costa, Ferreira Livia Cristina Fonseca, de Lima Marcella Morgado Ramiro, Netto Juliana Dos Santos Barbosa, Astacio Guis Saint-Martin, Bernardes-Engemann Andréa Reis, de Macedo Priscila Marques, Gutierrez-Galhardo Maria Clara, Freitas Dayvison Francis Saraiva

机构信息

Vice-Direção de Ensino, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil.

Laboratório de Pesquisa Clínica em DST/AIDS, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil.

出版信息

J Fungi (Basel). 2023 Sep 23;9(10):956. doi: 10.3390/jof9100956.

Abstract

Sporotrichosis is the most frequent subcutaneous or implantation mycosis in Latin America, and its transmission occurs as a result of traumatic inoculation into the skin by organic matter containing the thermodimorphic fungi of the genus . Although cutaneous forms are more common, another important site is the osteoarticular system, whose hematogenous involvement is commonly associated with disseminated forms, especially in people who have an immunosuppressive condition, such as HIV/AIDS, chronic steroid use, and alcohol abuse. We present two cases of osteoarticular sporotrichosis of the knee caused by and followed up at our institution, with different outcomes. In the cases presented here, aging, anatomical sites, comorbidities, subtherapeutic serum levels, low adherence to treatment, and late diagnosis for different reasons may explain the observed outcomes. Early diagnosis of infection is critical in preventing complications, including death. We also highlight the importance of multidisciplinary follow-up and adherence to treatment for a favorable outcome.

摘要

孢子丝菌病是拉丁美洲最常见的皮下或植入性真菌病,其传播是由于含有该属双相真菌的有机物经创伤接种到皮肤所致。虽然皮肤型更为常见,但另一个重要部位是骨-关节系统,其血行感染通常与播散型相关,尤其是在患有免疫抑制疾病的人群中,如艾滋病毒/艾滋病、长期使用类固醇和酗酒者。我们报告了两例由申克孢子丝菌引起的膝关节骨-关节孢子丝菌病病例,并在我们机构进行了随访,结果不同。在此呈现的病例中,年龄、解剖部位、合并症、血清治疗水平低、治疗依从性差以及因不同原因导致的诊断延迟可能解释了观察到的结果。申克孢子丝菌感染的早期诊断对于预防包括死亡在内的并发症至关重要。我们还强调了多学科随访和坚持治疗以取得良好结果的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2e2/10607728/6ca65fdd8dbd/jof-09-00956-g001.jpg

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