Smith A G, Bustamante C I, Wood C
Department of Medical and Research Technology, University of Maryland, School of Medicine, Baltimore.
Mycopathologia. 1993 Apr;122(1):15-20. doi: 10.1007/BF01103704.
A 35 year old female patient with acute lymphocytic leukemia developed fusariosis in which dissemination appeared to be limited to cutaneous and vascular invasion. The first evidence of fungemia occurred nearly seven months after initial hospitalization. The fungus was identified as Fusarium sp. and was considered a contaminant. Two weeks later blood cultures were again positive for Fusarium sp. and the patient was placed on amphotericin B and 5-fluorocytosine therapy. The following day developing lesions were noted on her forearms and face; lesions ultimately spread to her trunk, abdomen, and lower extremities. Skin lesion biopsy sections revealed abundant septate and branching hyphae throughout the dermis and within capillaries. Twenty-six days after the initial isolation the patient died. Post-mortem blood cultures gave rise to the same fungus, which was identified as Fusarium moniliforme. Postmortem cultures and stains of spleen, liver, lung, and brain specimens were all negative for fungi. The primary source and portal of entry of the organism remained undetermined.
一名35岁的急性淋巴细胞白血病女性患者发生了镰刀菌病，其播散似乎仅限于皮肤和血管侵袭。初次住院近七个月后首次出现真菌血症迹象。该真菌被鉴定为镰刀菌属，起初被认为是污染物。两周后，血培养再次显示镰刀菌属阳性，患者开始接受两性霉素B和5-氟胞嘧啶治疗。第二天，在她的前臂和面部发现了新出现的皮损；皮损最终蔓延至她的躯干、腹部和下肢。皮肤病变活检切片显示，整个真皮层和毛细血管内有大量具隔和分支的菌丝。初次分离出真菌26天后，患者死亡。尸检血培养再次培养出相同真菌，被鉴定为串珠镰刀菌。脾脏、肝脏、肺和脑标本的尸检培养和染色均未发现真菌。该病原体的主要来源和侵入途径仍未明确。
