Hu Xin, Zhang Mingrui, Lv Sha, Liu Zhe, Nakagawa Ichiro, Li Fuqiu
Department of Microbiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Dermatology, The Second Hospital of Jilin University, Changchun, People's Republic of China.
Am J Trop Med Hyg. 2024 Dec 10;112(3):548-552. doi: 10.4269/ajtmh.23-0573. Print 2025 Mar 5.
Mycetoma is a granulomatous disease of subcutaneous tissue that is caused by different species of aerobic filamentous bacteria (actinomycetoma) or fungi (eumycetoma). Mycetoma treatment depends on the causative pathogen, and it mainly consists of antimicrobial interventions or surgery. Aspergillus terreus is an etiologic agent of invasive aspergillosis and a rare cause of eumycetoma that is common in central and southern China. The present case report describes a 45-year-old female patient with subcutaneous swelling and multiple active and healed sinuses over the dorsal aspect of the left foot who was diagnosed with eumycetoma caused by A. terreus. This is the first such case reported in China. We applied a combination treatment consisting of itraconazole with topical luliconazole cream and radiofrequency microneedling, and this was followed by significant regression of the lesion. In addition, we reviewed the current literature to summarize the epidemiological characteristics of mycetoma in mainland China and cases of eumycetoma caused by A. terreus worldwide.
足菌肿是一种皮下组织的肉芽肿性疾病,由不同种类的需氧丝状细菌(放线菌性足菌肿)或真菌(真菌性足菌肿)引起。足菌肿的治疗取决于致病病原体,主要包括抗菌干预或手术。土曲霉是侵袭性曲霉病的病原体,也是中国中部和南部罕见的真菌性足菌肿病因。本病例报告描述了一名45岁女性患者,其左脚背出现皮下肿胀以及多个活动期和愈合期的窦道,被诊断为由土曲霉引起的真菌性足菌肿。这是中国报道的首例此类病例。我们采用了伊曲康唑联合外用卢立康唑乳膏和射频微针的联合治疗方法,随后病变明显消退。此外,我们回顾了当前文献,总结了中国大陆足菌肿的流行病学特征以及全球范围内由土曲霉引起的真菌性足菌肿病例。