Kaufman L, Valero G, Padhye A A
Mycotic Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
J Clin Microbiol. 1998 Dec;36(12):3721-3. doi: 10.1128/JCM.36.12.3721-3723.1998.
We describe a case of coccidioidomycosis in which several unusual morphologic forms of Coccidioides immitis occurred in biopsy tissue from the right lower lung of a patient. To our knowledge, this is the first case where so many diverse morphologic forms were manifested in a single patient in the absence of typical endosporulating spherules. Immature spherules demonstrating segmentation mimicked morula forms of Prototheca spp. Certain elements resembled budding cells of Blastomyces dermatitidis. These consisted of juxtaposed immature spherules without endospores, a germinating endospore, or thick-walled hyphal cells. Branched, septate hyphae and moniliform hyphae consisting of chains of thick-walled arthroconidia or immature spherules were also present. Complement fixation and immunodiffusion tests performed on the patient's serum were negative for C. immitis, B. dermatitidis, and Histoplasma capsulatum antibodies. Fluorescent-antibody studies were carried out with a specific C. immitis conjugate. All of the diverse fungal tissue elements stained positive with a moderate to strong (2 to 3+) intensity.
我们描述了一例球孢子菌病病例，在该病例中，来自一名患者右下肺活检组织的粗球孢子菌出现了几种不寻常的形态形式。据我们所知，这是首例在无典型内生孢子的球形体情况下，单一患者体内出现如此多种不同形态形式的病例。显示出分割的未成熟球形体模仿了原藻属的桑葚形。某些成分类似于皮炎芽生菌的芽生细胞。这些包括并列的无内生孢子的未成熟球形体、一个正在萌发的内生孢子或厚壁菌丝细胞。还存在由厚壁关节孢子链或未成熟球形体组成的分支、有隔膜的菌丝和念珠状菌丝。对患者血清进行的补体结合试验和免疫扩散试验对粗球孢子菌、皮炎芽生菌和荚膜组织胞浆菌抗体均呈阴性。用特异性粗球孢子菌结合物进行了荧光抗体研究。所有不同的真菌组织成分均以中度至强（2至3 +）强度染色呈阳性。
