Mahmoudi Hamidreza, Ramezanalipour Zahra, Khansari Mahmoud, Meijer Eelco F J, Mahmoudi Shahram, Spruijtenburg Bram, Rahimi Foroushani Abbas, Gramishoar Mohsen, Kamali Sarvestani Hasti
Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Front Med (Lausanne). 2024 Jul 16;11:1396224. doi: 10.3389/fmed.2024.1396224. eCollection 2024.
Neglected tropical diseases (NTDs) pose a significant threat to the health of millions of people worldwide, particularly in impoverished populations in tropical and subtropical regions. The World Health Organization (WHO) considers certain fungal infections, such as chromoblastomycosis, as NTDs. Chromoblastomycosis is a chronic fungal infection affecting the skin and subcutaneous tissue, primarily found in tropical and subtropical regions of Latin America, Africa, and Asia. This case report presents a 46-year-old female patient with chromoblastomycosis who had a history of renal transplantation and was receiving immunosuppressive therapy. The patient exhibited dark, verrucous, and ulcerative lesions on the legs, and the diagnosis was confirmed through the microscopic examination of skin scrapings by observing medlar bodies. Two sequential fungal tissue cultures and ITS sequencing verified the presence of , not formerly described in chromoblastomycosis. Moreover, observation of fly larvae in the lesions verified the diagnosis of myiasis. Treatment with voriconazole and terbinafine resulted in complete resolution of the lesions after 5 months. This case emphasizes the importance of considering chromoblastomycosis in individuals with occupational exposure in tropical areas, as well as the challenges associated with its diagnosis, coinfections, and treatment.
被忽视的热带病（NTDs）对全球数百万人的健康构成重大威胁，尤其是热带和亚热带地区的贫困人口。世界卫生组织（WHO）将某些真菌感染，如着色芽生菌病，视为被忽视的热带病。着色芽生菌病是一种影响皮肤和皮下组织的慢性真菌感染，主要见于拉丁美洲、非洲和亚洲的热带和亚热带地区。本病例报告介绍了一名46岁患有着色芽生菌病的女性患者，她有肾移植病史且正在接受免疫抑制治疗。患者腿部出现深色、疣状和溃疡性病变，通过观察皮肤刮片中的枸杞小体进行显微镜检查确诊。连续两次真菌组织培养和ITS测序证实了 的存在，这在着色芽生菌病中以前未曾描述过。此外，在病变中观察到蝇蛆证实了蝇蛆病的诊断。伏立康唑和特比萘芬治疗5个月后病变完全消退。该病例强调了在热带地区有职业暴露的个体中考虑着色芽生菌病的重要性，以及其诊断、合并感染和治疗相关的挑战。
