Fonsecaea monophora所致皮膚著色芽生菌病3例病原學(xué)鑒定及臨床分析
發(fā)布時(shí)間:2018-05-16 09:45
本文選題:Fonsecaea + monophora; 參考:《中國(guó)皮膚性病學(xué)雜志》2015年08期
【摘要】:目的對(duì)3例Fonsecaea monophora所致皮膚著色芽生菌病進(jìn)行病原學(xué)鑒定及臨床分析。方法分析3例患者的臨床特點(diǎn)。取患者皮損膿液直接鏡檢,皮損組織病理學(xué)檢查及真菌培養(yǎng)。提取病原菌DNA,利用引物ITS4和ITS5進(jìn)行r DNA ITS區(qū)序列的PCR擴(kuò)增,擴(kuò)增產(chǎn)物測(cè)序后在Gen Bank核酸數(shù)據(jù)庫(kù)及CBS數(shù)據(jù)庫(kù)中進(jìn)行同源性比對(duì)。結(jié)果皮損組織病理表現(xiàn)為慢性肉芽腫樣改變,并可見(jiàn)硬殼小體。真菌培養(yǎng)可見(jiàn)暗棕色、橄欖色至黑色菌落生長(zhǎng),生長(zhǎng)速度較慢,鏡下可見(jiàn)枝孢型和喙枝孢型產(chǎn)孢。溫度實(shí)驗(yàn)37℃生長(zhǎng),38℃不生長(zhǎng)。0.01%,0.05%和0.1%放線菌酮均能耐受。經(jīng)序列分析與Gen Bank及CBS數(shù)據(jù)庫(kù)中Fonsecaea monophora的ITS區(qū)進(jìn)行同源性比對(duì),其同源性高。結(jié)合3例患者組織病理、真菌學(xué)特征及r DNA ITS區(qū)序列分析將病原菌鑒定為Fonsecaea monophora。確診后經(jīng)口服伊曲康唑200mg,2次/d,6~8周后以200mg,1次/d維持治療,或特比萘芬250mg,1次/d。治療3個(gè)月后,皮損逐漸消退。結(jié)論 Fonsecaea monophora與裴氏著色霉相似,可引起皮膚著色性芽生菌病,可通過(guò)分子生物學(xué)方法鑒別,口服伊曲康唑或特比萘芬治療有效。
[Abstract]:Objective to identify and analyze the etiology of 3 cases of dermatochromocytoma caused by Fonsecaea monophora. Methods the clinical features of 3 patients were analyzed. Direct microscopic examination, histopathological examination and fungal culture were performed. The ITS4 and ITS5 primers were used to amplify the r DNA ITS region by PCR. The amplified products were sequenced and compared with each other in the Gen Bank nucleic acid database and CBS database. Results the pathological features of the lesions were chronic granulomatous changes, and hard shell bodies could be seen. Fungus culture showed dark brown, olive-color to black colony growth, the growth rate was slow, under the microscope can be seen in the cytosporium type and the beak Cladosporium type sporulation. In the temperature experiment, 37 鈩,
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