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[加蓬的耳霉病(鼻面部虫霉病)。关于一例病例]

[Conidiobolomycosis (rhinofacial entomophthoromycosis) in Gabon. About of one case].

作者信息

Ntsame Ngoua Stéphanie, Iba Ba Josaphat, Coniquet Sophie, Moussirou Soumbou Ghislaine, Boguikouma Jean Bruno

机构信息

Service de dermatologie, CHU de Libreville, Libreville, Gabon.

Service de médecine interne, CHU de Libreville, Libreville, Gabon.

出版信息

Med Trop Sante Int. 2023 Dec 13;3(4). doi: 10.48327/mtsi.v3i4.2023.457. eCollection 2023 Dec 31.

Abstract

BACKGROUND

Entomophthoromycosis constitutes a nosological group of subcutaneous mycoses including conidiobolomycosis (rhinofacial form) and basidiobomomycosis (subcutaneous form involving the trunk and the limbs). Conidiobolomycosis is characterized by a progressive nasal and facial deformity giving, in the evolved forms, a "hippopotamus snout". The literature review finds a hundred cases, with a tropism for the humid tropical regions. Methods. We report the observation of a 25-year-old patient, living in the equatorial zone, in the south of Gabon in a humid forest area, presenting a swollen aspect of the face mainly involving the eyelids, the nose and the upper lips.

RESULTS

The diagnosis of entomophthoromycosis was compatible with the histopathological and clinical aspects. The evolution was favorable in terms of facial aesthetics under itraconazole 300 mg/day for 2 months and corticosteroid therapy (bolus of methylprednisone 240 mg/day for 3 days relayed per os at a dose of 0.5 mg/kg/day, i.e. 30 mg/day) of prednisone), maintained for 3 months. The average nasal improvement could not be completed by surgery and the patient was lost to follow-up.

CONCLUSION

This second observation of conidiobolomycosis in Gabon in the same province makes Ngounié a privileged ecosystem for this affection.

摘要

背景

虫霉病是一组皮下真菌病,包括耳霉病(鼻面部型)和蛙粪霉病(累及躯干和四肢的皮下型)。耳霉病的特征是进行性鼻面部畸形,在病情进展时会出现“河马鼻”。文献综述发现了100例病例,该病多见于潮湿的热带地区。方法。我们报告了一名25岁患者的病例,该患者生活在赤道地区,位于加蓬南部的一个潮湿森林地区,面部肿胀,主要累及眼睑、鼻子和上唇。

结果

虫霉病的诊断与组织病理学和临床症状相符。在服用伊曲康唑300毫克/天,持续2个月以及皮质类固醇治疗(甲基强的松龙大剂量冲击治疗,240毫克/天,持续3天,之后口服泼尼松,剂量为0.5毫克/千克/天,即30毫克/天),持续3个月的情况下,面部美观方面的病情进展良好。手术未能完全改善鼻部外观,该患者失访。

结论

加蓬同一省份第二次出现耳霉病病例,这使得恩古涅成为该病的一个特殊生态区域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/202f/10879889/c5c84509ee3f/mtsi-03-5487-g001.jpg

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