Nahass G T, Rosenberg S P, Leonardi C L, Penneys N S
Department of Internal Medicine, University Medical Center, St. Louis, Mo.
Arch Dermatol. 1993 Aug;129(8):1020-3. doi: 10.1001/archderm.129.8.1020.
Trichosporonosis is a potentially life-threatening disseminated infection with Trichosporon beigelii, the causative agent of the white piedra. Systemic infection by this fungus has been most frequently described in immunocompromised hosts with neutropenia, but one case has been reported in the acquired immunodeficiency syndrome setting. We report a second case of trichosporonosis in a patient with acquired immunodeficiency syndrome and review the clinical and histologic characteristics of cutaneous involvement with this opportunistic fungal pathogen.
Trichosporonosis occurs most commonly in neutropenic patients receiving chemotherapy. We describe the second case developing in the acquired immunodeficiency syndrome setting. Cutaneous involvement occurred in approximately 30% of patients and most frequently presented as purpuric papules and nodules with central necrosis or ulceration. Biopsy specimens of these lesions revealed dermal invasion by fungal elements, and culture was positive in greater than 90% of the cases.
Disseminated infection with T beigelii can occur in immunosuppressed patients, including those with acquired immunodeficiency syndrome particularly if associated with neutropenia. Cutaneous involvement is common, presenting as purpuric papules and nodules. Biopsy and culture of cutaneous findings can help establish an accurate diagnosis resulting in rapid and appropriate treatment.
白吉利丝孢酵母是白癣的病原体，丝孢酵母病是一种潜在威胁生命的播散性感染。这种真菌的全身感染最常发生在免疫功能低下且伴有中性粒细胞减少的宿主中，但在获得性免疫缺陷综合征（AIDS）患者中也有过一例报道。我们报告了第二例AIDS患者发生丝孢酵母病的病例，并回顾了这种机会性真菌病原体皮肤受累的临床和组织学特征。
丝孢酵母病最常见于接受化疗的中性粒细胞减少患者。我们描述了第二例发生在AIDS患者中的病例。约30%的患者出现皮肤受累，最常见的表现为紫癜性丘疹和结节，伴有中央坏死或溃疡。这些病变的活检标本显示真菌成分侵入真皮，超过90%的病例培养呈阳性。
白吉利丝孢酵母的播散性感染可发生在免疫抑制患者中，包括AIDS患者，特别是伴有中性粒细胞减少的患者。皮肤受累很常见，表现为紫癜性丘疹和结节。对皮肤表现进行活检和培养有助于准确诊断，从而实现快速和适当的治疗。
