Dooley D P, Bostic P S, Beckius M L
Department of Medicine, Brooke Army Medical Center, Ft Sam Houston, Tex, USA.
Arch Intern Med. 1997 Sep 8;157(16):1885-7. doi: 10.1001/archinte.157.16.1885.
While isolated cases of sporotrichosis typically occur following contact with contaminated plant materials, outbreaks are distinctly unusual. A temporal increase in the incidence of sporotrichosis in a dermatology practice at a military installation in southwestern Oklahoma prompted an investigation. Patients with sporotrichosis presenting to a single dermatologist in the winter of 1992-1993 were interviewed, epidemiological data were collected, and fungal cultures were obtained from incriminated hay fields. Five patients presented with cutaneous sporotrichosis during a 5-week period beginning in December 1992. Four patients had maintained hay bales in a Halloween haunted house and the fifth patient had visited the house once. As in 3 previous reports, this outbreak was associated with stored hay or hay bales harvested in the US plains states. Contact with hay should be recognized as a risk factor for infection with Sporothrix schenckii. Outbreaks are possible given adequate intensity of exposure and may be difficult to recognize because of the delayed presentation of clinical illness.
虽然孢子丝菌病的孤立病例通常在接触受污染的植物材料后发生,但暴发情况极为罕见。俄克拉荷马州西南部一个军事基地皮肤科诊所孢子丝菌病发病率的暂时上升促使展开了一项调查。对1992 - 1993年冬季到一名皮肤科医生处就诊的孢子丝菌病患者进行了访谈,收集了流行病学数据,并从可疑的干草田采集了真菌培养物。从1992年12月开始的5周内有5名患者出现皮肤孢子丝菌病。4名患者曾在一个万圣节鬼屋中存放干草捆,第5名患者曾去过该鬼屋一次。与之前的3份报告一样, 此次暴发与在美国平原各州收获并储存的干草或干草捆有关。应认识到接触干草是申克孢子丝菌感染的一个危险因素。在有足够暴露强度的情况下可能会暴发,而且由于临床疾病出现延迟,可能难以识别。