Revankar S G, Sutton D A, Sanche S E, Rao J, Zervos M, Dashti F, Rinaldi M G
University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
J Clin Microbiol. 1999 Jan;37(1):195-8. doi: 10.1128/JCM.37.1.195-198.1999.
Metarrhizium anisopliae is a common pathogen of insects and has even been used to control insect populations. It is rarely isolated from human or animal sources, but recently, there have been three reported cases of disease, two in humans and one in a cat. We present our experience with five isolates from human sources, including two that were the apparent causes of two cases of sinusitis in immunocompetent hosts. The first patient was a 36-year-old male with frontal and ethmoid sinusitis, and the second was a 79-year-old female with chronic sinusitis. Both patients underwent surgery, and pathology of the surgical specimens revealed branching hyphae. Cultures grew only Metarrhizium species. Neither patient received antifungal therapy, and both did well postoperatively. The other three isolates were cultured from bronchoalveolar lavage specimens but were not felt to be clinically significant. Antifungal susceptibility testing using the National Committee for Clinical Laboratory Standards macrobroth method revealed that all isolates were resistant to amphotericin B, 5-flucytosine, and fluconazole. Itraconazole and newer azole compounds were more active. Metarrhizium species may cause disease in humans, even those without evidence of immunosuppression, and are apparently highly resistant to amphotericin B in vitro.
绿僵菌是昆虫的常见病原体，甚至已被用于控制昆虫种群。它很少从人类或动物源分离得到，但最近有三例疾病报告，两例发生在人类，一例发生在猫身上。我们介绍了从人类源分离的五株菌株的经验，其中两株显然是免疫功能正常宿主中两例鼻窦炎的病因。第一例患者是一名36岁男性，患有额窦和筛窦炎，第二例是一名79岁女性，患有慢性鼻窦炎。两名患者均接受了手术，手术标本的病理显示有分支菌丝。培养物仅长出绿僵菌属菌种。两名患者均未接受抗真菌治疗，术后恢复良好。另外三株菌株是从支气管肺泡灌洗标本中培养出来的，但被认为无临床意义。使用美国国家临床实验室标准委员会的大管液体稀释法进行的抗真菌药敏试验显示，所有菌株对两性霉素B、5-氟胞嘧啶和氟康唑均耐药。伊曲康唑和新型唑类化合物活性更高。绿僵菌属菌种可能会导致人类发病，即使是那些没有免疫抑制证据的人，并且在体外对两性霉素B显然具有高度耐药性。
