念珠菌所致深部皮肤软组织感染的回顾性分析

摘要/Abstract

摘要：

目的分析念珠菌所致深部皮肤软组织感染的特点。方法检索pubmed、万方数据库及中国期刊全文数据库中念珠菌所致深部皮肤软组织感染的病例报告建立数据库进行描述性分析，时间限定为1984-2017年。结果共获得32篇文献，涉及35例患者。世界各地均有分布，中国报道最多，男女比例大致相当。大部分念珠菌所致深部皮肤软组织感染患者均有基础疾病或存在诱发因素。念珠菌所致深部皮肤软组织感染临床表现多种多样，约一半以上表现为皮肤溃疡，其中面部中线区域溃疡亦不占少数。也可模拟许多疾病的临床表现如毛囊炎、蜂窝织炎、坏死性筋膜炎等，还可表现为皮下脓肿、皮肤斑块等。所有病例均通过真菌培养确诊。病理下可见假菌丝和（或）孢子。结论念珠菌所致深部皮肤软组织感染临床表现多样，大部分表现为溃疡，其中面部损毁性溃疡是常见类型，可模拟多种疾病表现，临床上易造成误诊。病理下可见假菌丝和（或）孢子，病理组织中假菌丝较少，以孢子为主，这可能是造成临床误诊的原因。病损局限或基础病较轻患者预后较好，基础病较重或出现系统播散可致死亡。致病菌种以白念珠菌为主。

关键词: 念珠菌, 皮肤感染, 皮下组织

Abstract:

Objective To analyze clinical feature of skin and soft tissue infections caused by Candida spp.Methods Perform discriptive analysis of Candida infection case reports published from 1984-2017 in Pubmed, Wanfang and CNKI Database. Results Thirty-five patients in 32 literatures were analyzed. Every age group was involved worldwide, with more cases in China, roughly the same proportion of males and females. Almost all of the patients had an underlying disease or predisposing factors. Deep skin and soft tissue infections caused by Candida spp. had various clinical manifestations. More than half of cases showed skin ulcers.Facial midline area ulcers were not unusual, which could also simulate the clinical manifestations of many diseases such as folliculitis, cellulitis, necrotizing fasciitis and so on, or presented as subcutaneous abscess, skin patches, ect. All cases were confirmed by fungal culture. Pseudohyphae and (or) spores could be found in histopathological examination.Conclusion Deep skin and soft tissue infections caused by Candida spp. had various clinical features, which mostly manifested as ulcers, and could simulate a variety of diseases, easily leading to misdiagnosis. Pseudohyphae and (or) spores could be found in histopathological examination. Patients with limited lesion or mildly underlying disease had a favourable prognosis, severe underlying disease or the emergence of systematic spread could cause death. The main pathogen was Candida albicans.

Key words: Candida, Skin infection, Subcutaneous

中图分类号:

R519.3

陈萍, 周亚彬, 李东明. 念珠菌所致深部皮肤软组织感染的回顾性分析[J]. 中国真菌学杂志, 2018, 13(4): 217-222.

CHEN Ping, ZHOU Ya-bin, LI Dong-ming. Literature review of skin and soft tissue infections caused by Candida spp.[J]. Chinese Journal of Mycology, 2018, 13(4): 217-222.

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