少见尖端赛多孢子菌致脑组织感染1例及系列研究

中国真菌学杂志　 2018, Vol. 13 　Issue (5): 294-296,304.

少见尖端赛多孢子菌致脑组织感染1例及系列研究

周馨, 马筱玲, 叶书来, 鲁怀伟, 王影

中国科技大学附属第一医院检验科, 合肥 230001

收稿日期:2018-04-24 出版日期:2018-10-28 发布日期:2018-10-28
通讯作者: 王影,E-mail:18256526009@163.com E-mail:18256526009@163.com
作者简介:周馨,女(汉族),硕士,主管检验师.E-mail:zhouxin1806@163.com

A rarecase report of encephalopyosis induced by Scedosporium apiospermum: identification of causativeagent and antifungal susceptibility testing in vitro

ZHOU Xin, MA Xiao-ling, YE Shu-lai, LU Huai-wei, WANG Ying

Department of clinical laboratory, The First Affiliated Hospital of USTC, Hefei 230001

Received:2018-04-24 Online:2018-10-28 Published:2018-10-28

摘要/Abstract

摘要：

目的报道尖端赛多孢子菌脑脓肿感染1例，并探讨真菌的鉴定及其对抗真菌药物体外药敏试验。方法取患者颅内引流物标本进行真菌培养和形态学鉴定，对分离菌做基因测序和抗真菌药物体外药敏试验。结果根据菌株的形态学特点和基因测序结果鉴定为尖端赛多孢子菌，药敏试验显示对两性青霉素B、氟康唑耐药，对伏立康唑敏感。结论尖端赛多孢子菌导致的真菌感染较少见，其鉴定主要依靠形态学特征和基因分析。伏立康唑对该菌株有较好的治疗作用。

关键词: 尖端赛多孢子菌, 脑脓肿, 真菌鉴定, 药敏试验

Abstract:

Objective Reported one case of encephalopyosis caused by Scedosporium apiospermum. To explore the identification of fungi and its antifungal susceptibility tests in vitro. Methods The patient's intracranial drainage specimens were taken for fungal culture and morphological identification, and the isolates were subjected to gene sequencing and antifungal drug in vitro susceptibility test. Results According to the morphological characteristics of the strain and the results of gene sequencing, it was identified as Scedosporium apiospermum. Scedosporium apiospermum was sensitivity to voriconazole but resistant tofluconazole and amphotericin B. Conclusions Fungal infections caused by Scedosporium apiospermum are less common and their identification relies primarily on morphological features and genetic analysis. Voriconazole has a good therapeutic effect on this strain.

Key words: Scedosporium apiospermum, encephalopyosis, fungal identification, antifungal susceptibility testing

中图分类号:

R519

周馨, 马筱玲, 叶书来, 鲁怀伟, 王影. 少见尖端赛多孢子菌致脑组织感染1例及系列研究[J]. 中国真菌学杂志, 2018, 13(5): 294-296,304.

ZHOU Xin, MA Xiao-ling, YE Shu-lai, LU Huai-wei, WANG Ying. A rarecase report of encephalopyosis induced by Scedosporium apiospermum: identification of causativeagent and antifungal susceptibility testing in vitro[J]. Chinese Journal of Mycology, 2018, 13(5): 294-296,304.

参考文献

[1] 王端礼.医学真菌学一实验室检查指南[M].北京:人民卫生出版社.2005:435-439.
[2] Makimura K, Murayama SY, Yamaguchi H.Detection of a wide range of medicalimportant fungi by the PCR[J]. J Med Mycol, 1994, 40(5):358-364.
[3] National Committee for Clinical Laboratory Standards.Reference method for broth dilution antifungal susceptibility testing of filamentous fungi[S]. Approved standard M38-ANational Committee for ClinicalLaboratory Standards,Wayne, Pa, 2002.
[4] Stripeli F, Pasparakis D, Velegraki A,et al. Scedosporium apiospermum skeletal infection in an immunocompetent child[J].Med Mycol,2009,47(4):398-405.
[5] 钟一鸣,晏群,李虹玲,等.颅内尖端赛多孢子菌感染致脑脓肿一例并文献复习[J].中华检验医学杂志,2013,36(11):1050-1051.
[6] 李军,胡咏梅,王海晨,等.外伤引发尖端赛多孢颅内感染1例[J].临床检验杂志,2017,35(10):788-789.
[7] Signore SC, Dohm CP, Schütze G, et al.Scedosporium apiospermum brain abscesses in a patient after near-drowning-a case report with 10-year follow-up and a review of the literature[J].Med Mycol Case Rep,2017,17(C):17-19.
[8] 黄琨,郑岳臣. 尖端赛多孢子菌真菌学及实验室研究进展[J].中国真菌学杂志,2007,2(4):247-249.
[9] TóthEJ, Nagy GR, Homa M,et al. Recurrent Scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment:a case report and review of the literature[J].Ann Clin Microbiol Antimicrob,2017,16(1):31.
[10] 周树生,承韶辉.尖端赛多孢菌感染1例[J].中国感染与化疗杂志,2009,9(6):466-468.
[11] Mursch K, Trnovec S, Ratz H,et al. Successful treatment of multiple Pseudallescheria boydii brain abscesses and ventriculitis/ependymitis in a 2-year-old child after a near-drowning episode[J].Childs Nerv Syst, 2006, 22(2):189-192.

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