Rohwedder J J, Simmons J L, Colfer H, Gatmaitan B
Arch Intern Med. 1979 Aug;139(8):940-1.
For ten years, a 25-year-old immune-competent man experienced a progressive disseminated infection with the saprophytic soil fungus, Curvularia lunata, following presumptive cutaneous inoculation while playing football. Deep, soft tissue abscesses, pulmonary suppuration, paravertebral abscess, and cerebral abscess all followed leg ulcers from neglected abrasions. The patient's delay in obtaining treatment was partially responsible for the paravertebral-mediastinal-pleural-cutaneous fistula that resulted. The importance of prompt and aggressive surgical drainage procedures is clear. Infection was arrested only by surgery. The fungus was inhibited by miconazole nitrate and amphotericin B but it developed resistance to flucytosine. Miconazole appeared to cause resolution of the cerebral abscess. Amphotericin B (1 mg/kg/day) clearly was beneficial but only after effective drainage procedures were done. The patient refused to continue amphotericin B after 5.4 g had been given in two treatments. He became bedridden one year later from back pain that was caused by recurrent disease.
十年来，一名25岁免疫功能正常的男性在踢足球时可能因皮肤接种，感染了腐生性土壤真菌新月弯孢霉，并出现进行性播散性感染。因被忽视的擦伤导致腿部溃疡，进而引发深部软组织脓肿、肺化脓、椎旁脓肿和脑脓肿。患者延误治疗是导致椎旁-纵隔-胸膜-皮肤瘘形成的部分原因。及时且积极的外科引流手术的重要性显而易见。仅通过手术才控制住感染。硝酸咪康唑和两性霉素B可抑制该真菌，但它对氟胞嘧啶产生了耐药性。咪康唑似乎使脑脓肿消退。两性霉素B（1毫克/千克/天）显然有益，但仅在进行有效的引流手术后才起作用。在两次治疗中给予5.4克两性霉素B后，患者拒绝继续使用。一年后，他因复发性疾病引起的背痛而卧床不起。
