Microsphaeropsis arundinis引起右前臂皮肤暗色丝孢霉病1例及文献分析

中国真菌学杂志　 2022, Vol. 17 　Issue (3): 220-224.

Microsphaeropsis arundinis引起右前臂皮肤暗色丝孢霉病1例及文献分析

杨虹, 高志琴, 刘思禹, 谭静文, 徐红, 陈健, 杨连娟

上海市皮肤病医院真菌病科, 同济大学附属皮肤病医院, 上海 200443

收稿日期:2021-12-14 出版日期:2022-06-28 发布日期:2022-07-02
通讯作者: 杨连娟,E-mail:zhy52808290@qq.com E-mail:zhy52808290@qq.com
作者简介:杨虹,女(汉族),硕士,副主任医师.E-mail:yanghcn@sina.com
基金资助:
上海市卫生健康委员会临床专项项目(201940476)

Subcutaneous phaeohyphomycosis caused by Microsphaeropsis arundinis：a case report and review of the literatures

YANG Hong, GAO Zhiqin, LIU Siyu, TAN Jingwen, XU Hong, CHEN Jian, YANG Lianjuan

Department of Mycology, Shanghai Skin Disease Hospital, Skin Disease Hospital of Tongji University, Shanghai 200443, China

Received:2021-12-14 Online:2022-06-28 Published:2022-07-02

摘要/Abstract

摘要： 患者,男,80岁,农民,右前臂外侧浸润性红斑、结节、结痂1年余,糖尿病史10年。右前臂外侧可见浸润性红斑、斑块上间有小结节和疣状增生,上覆有黑色结痂,皮损面积5 cm×10 cm。刮取皮屑直接镜检发现菌丝,活检组织标本真菌直接镜检也发现菌丝。真菌培养均长出灰褐色绒毛状菌落,周围有灰白色边缘。玻片小培养可见分隔菌丝,个别节段膨大,分生孢子呈椭球形。表皮假上皮瘤样增生、真皮内可见淋巴细胞、中性粒细胞、组织细胞以及多核巨细胞浸润的肉芽肿性炎症。过碘酸-雪夫(PAS)染色显示,真皮内有多个紫红色圆形芽殖孢子。分离菌株的分子测序结果与Microsphaeropsis arundinis的ITS片段序列100%符合。口服伊曲康唑胶囊400 mg/d,5个月后皮损得到明显改善,目前仍在治疗和观察中。回顾2000年-2021年M.arundinis引起相关感染的国内外文献,探讨M.arundinis导致暗色丝孢霉病的临床特征。

关键词: 皮肤暗色丝孢霉病, Microsphaeropsis arundinis, 糖尿病

Abstract: A 80-year-old male farmer presented with invasive erythema on the right forearm for more than 1 year. He had 10-year history of Diabetes Mellitus. Dermatological examination revealed diffuse, invasive erythema on the right forearm, with warty hyperplasia, covered with black scab, skin damage area 5 cm×10 cm. Direct microscopic examination of the scurf and lesional tissue both showed branched hyphae.Culture showed grew dark gray, velvety colonies with grey-white edge on SDA. Microscopic morphology showed septate, irregularly shaped hyphae with oval, ellipsoidal conidia. Histopathological examination of the lesional tissue revealed Periodic-acid-Schiff (PAS)-positive spore-1ike structures. Sequencing analysis of the internal transcribed spacer (ITS) region revealed 100% consistence between the clinical isolate and reference strain of Microsphaeropsis arundinis. The patient was diagnosed with subcutaneous phaeohyphomycosis caused by M.arundinis. The patient was given itraconazole 400 mg daily orally. Five months later, the skin 1esions was noted to be improved. The patient was still under treatment and observation. The clinical characteristics of phaeohyphomycosis induced by M. arundinis were discussed by reviewing the literatures on infection caused by M. arundinis from 2000 to 2021.

Key words: Subcutaneous phaeohyphomycosis, Microsphaeropsis arundinis, diabetes mellitus

中图分类号:

杨虹, 高志琴, 刘思禹, 谭静文, 徐红, 陈健, 杨连娟. Microsphaeropsis arundinis引起右前臂皮肤暗色丝孢霉病1例及文献分析[J]. 中国真菌学杂志, 2022, 17(3): 220-224.

YANG Hong, GAO Zhiqin, LIU Siyu, TAN Jingwen, XU Hong, CHEN Jian, YANG Lianjuan. Subcutaneous phaeohyphomycosis caused by Microsphaeropsis arundinis：a case report and review of the literatures[J]. Chinese Journal of Mycology, 2022, 17(3): 220-224.

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