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播散性原绿球藻病:病例报告及文献复习。

Disseminated protothecosis: Case report and review of the literature.

机构信息

Department of Dermatology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

出版信息

J Cutan Pathol. 2024 Sep;51(9):705-713. doi: 10.1111/cup.14668. Epub 2024 Jun 11.

Abstract

BACKGROUND

Human protothecosis is an uncommon infection caused by Prototheca spp that rarely infects humans.

AIM

Description of a rare disease and a review of its articles.

MATERIALS AND METHODS

We reported a 24-year-old man who presented with red-brown papules and plaques on the trunk's lateral side. We reviewed the literature about disseminated protothecosis and reported our experience with a patient with protothecosis between 2021 and 2023.

RESULTS

Overall, 54 cases of disseminated protothecosis were evaluated, 39 were due to P. wickerhamii, 12 were due to P. zopfii (22.2%), and three were due to Prototheca spp. We found that males were more affected (37 cases, 68.5%) than females (16 cases, 29.6%). The mean age of patients was 39.53 ± 22.48 years. However, disseminated protothecosis can affect people of any age (1-80 years). In contrast to P. wickerhamii, which causes blood, skin, brain, and gastrointestinal tract infections, P. zopfii was mainly found in the blood (7/22) and did not have a significant difference in the mortality rate (P = 0.11).

DISCUSSION

Disseminated protothecosis is a rare disease in immunocompromised patients but is generally rarer in immunocompetent hosts. Several underlying disorders include immunocompromised patients, prolonged application of steroids, diabetes mellitus, malignancies, organ transplantation, AIDS, and surgeries. Amphotericin B has been the most effective agent for protothecosis and is reserved for visceral and disseminated infections. Regarding localized cutaneous types, excision or surgical debridement is used.

CONCLUSION

Mulberry's appearance and appropriate cultural environments are helpful in diagnosing it.

摘要

背景

人体原绿球藻病是一种由原绿球藻属引起的罕见感染,很少感染人类。

目的

描述一种罕见疾病,并对其文献进行回顾。

材料和方法

我们报告了一例 24 岁男性,其躯干侧面出现红棕色丘疹和斑块。我们回顾了关于播散性原绿球藻病的文献,并报告了我们在 2021 年至 2023 年期间治疗的一例原绿球藻病患者的经验。

结果

总体而言,评估了 54 例播散性原绿球藻病,其中 39 例由 P. wickerhamii 引起,12 例由 P. zopfii 引起(22.2%),3 例由原绿球藻属引起。我们发现男性(37 例,68.5%)比女性(16 例,29.6%)更容易受影响。患者的平均年龄为 39.53±22.48 岁。然而,播散性原绿球藻病可影响任何年龄的人群(1-80 岁)。与主要引起血液、皮肤、大脑和胃肠道感染的 P. wickerhamii 不同,P. zopfii 主要存在于血液中(7/22),死亡率无显著差异(P=0.11)。

讨论

播散性原绿球藻病是免疫功能低下患者的罕见疾病,但在免疫功能正常的宿主中通常较少见。几种潜在疾病包括免疫功能低下患者、长期应用类固醇、糖尿病、恶性肿瘤、器官移植、艾滋病和手术。两性霉素 B 一直是治疗原绿球藻病最有效的药物,保留用于内脏和播散性感染。对于局限性皮肤类型,使用切除或手术清创。

结论

桑椹外观和适当的培养环境有助于诊断。

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