Sautter R E, Bliss M D, Morrow D, Lee R E
Mycopathologia. 1984 Aug 30;87(1-2):105-9. doi: 10.1007/BF00436637.
Exophiala jeanselmei was isolated from three esophageal cultures over an 11-month period at Lutheran General Hospital. We believe this provides evidence for a new site of isolation, since previous reports of the organism's incidence were confined to skin and lung. Case 1 is an eight-year-old female with a three-year history of gagging and vomiting. Esophagoscopy revealed a mass biopsied as vegetable material. Case 2 is a 66-year-old retired male with a history of obesity, diabetes and spinal stenosis. Following back surgery, the patient developed odynophagia. Esophageal biopsies showed ulceration and bacterial colonies with no evidence of fungus. Case 3 is a 62-year-old male gardener who is also a nail biter. Esophagoscopy revealed a gastro-esophageal stricture with reflux and evidence of a hiatus hernia. Material biopsied was consistent with Barrett's esophagus and evidence of fungi was seen. The esophageal mass of case 1 and the esophageal brushings of case 2 and 3 grew E. jeanselmei. Aspiration, reflux, and mechanical disruption of the esophageal mucosa are possible predisposing factors in colonization of esophageal lesions by this ubiquitous, normally low virulence organism.
在11个月的时间里，从路德总医院的三份食管培养物中分离出了琼氏外瓶霉。我们认为这为一个新的分离部位提供了证据，因为此前关于该菌发病率的报告仅限于皮肤和肺部。病例1是一名8岁女性，有3年的 gagging和呕吐病史。食管镜检查发现一个肿块，活检为植物性物质。病例2是一名66岁的退休男性，有肥胖、糖尿病和椎管狭窄病史。背部手术后，患者出现吞咽痛。食管活检显示溃疡和细菌菌落，无真菌证据。病例3是一名62岁的男性园丁，也是一名咬指甲者。食管镜检查发现胃食管狭窄伴反流，并有食管裂孔疝的证据。活检材料与巴雷特食管一致，可见真菌证据。病例1的食管肿块以及病例2和病例3的食管刷检培养出了琼氏外瓶霉。吸入、反流以及食管黏膜的机械性损伤可能是这种普遍存在、通常毒力较低的生物体在食管病变定植的易感因素。
