Ben Rejeb A, Boubaker S, Turki I, Massaoudi L, Chibani M, Khouja H
Service d'Anatomie pathologique, Hôpital Militaire, Tunis, Tunisie.
J Gynecol Obstet Biol Reprod (Paris). 1993;22(1):85-9.
The authors report an original case-history of massive aspergillosis of the placenta that occurred in a 24 year old primigravida who had had no previous history or clinical changes in pregnancy. It caused fetal death in utero with retention and maceration of the fetus. Macroscopic examination showed that the left lip was cleft and that the placenta was studded with isolated confluent diffuse whitish granulations. Histologic examination made us think that these appearances were those of aspergillar granulomas occurring even in the placental villi and intravillous spaces. Laboratory findings showed that there was Aspergillus Niger in the blood of the mother. A wide search of the literature failed to find any case in humans. On the other hand aspergillosis occurs frequently in animals causing intrauterine growth retardation and prematurity with abortion. There is great economic loss as a result. Why the animal placenta should be susceptible to infection of aspergillosis and how it acquires it is discussed! Finally the association of aspergillosis of the placenta with a cleft lip found in our case, is unique and one wonders if there is any relationship.
作者报告了一例原发性胎盘曲霉菌病的病例，该病例发生在一名24岁的初产妇身上，她既往无病史，孕期也无临床变化。该病导致胎儿宫内死亡，胎儿滞留并浸软。宏观检查显示左侧唇裂，胎盘布满孤立的融合性弥漫性白色颗粒。组织学检查使我们认为这些表现是曲霉菌肉芽肿，甚至出现在胎盘绒毛和绒毛间隙。实验室检查结果显示母亲血液中有黑曲霉。广泛查阅文献未发现人类有类似病例。另一方面，曲霉菌病在动物中频繁发生，可导致宫内生长迟缓、早产和流产，造成巨大经济损失。本文讨论了动物胎盘为何易受曲霉菌感染以及如何感染。最后，我们病例中发现的胎盘曲霉菌病与唇裂的关联是独特的，不禁让人猜测它们之间是否存在某种关系。
