小型无绿藻性脑膜炎及其真菌学研究

Mycologic study of a case of Prototheca wickerhamii meningitis

目的探讨1例罕见的小型无绿藻性脑膜炎,研究致病菌的特征。方法对致病菌做直接镜检、培养、温度试验、放线菌酮耐受及碳源同化、电镜鉴定及药敏试验和动物感染试验。结果菌种鉴定为小型无绿藻,动物感染模型证实菌株具有致病力,经抗真菌治疗后痊愈。结论小型无绿藻是一种罕见的条件致病真菌,可感染免疫系统正常的患者,两性霉素B联合伊曲康唑注射液治疗有效。

Objective To study a rare case of meningitis due to Prototheca wickerhamii and the characteristics of this pathogen. Methods The following tests were performed： Direct microscopic examination, fungal culture, temperature resistance test, cycloheximide tolerance test, carbohydrates assimilation test, scanning electron microscopic examination, and antifimgal susceptibility test. API 20C AUX system was used to identify the fungus. Animal infection model was established. Results The pathogen was identified as P. wickerhamii. The pathogenicity of the isolate was confirmed by animal infection test. The patient was successfully treated with amphotericin B and itraconazole. Conclusions Prototheca wickerhamii is a rare opportunistic organism, which can infect individuals with normal immunity. Amphotericin B combined with itraconazole is effective for the infection caused by this organism.