国内首见棒状弯孢所致的皮肤暗色丝孢霉病

Subcutaneous Phaeohyphomycosis Caused by Curvularia clavata: The First Case Report in China

目的报道国内首见棒状弯孢所致的皮肤暗色丝孢霉病1例。方法取皮损标本直接镜检、真菌培养和组织病理学检查,并根据其镜下形态鉴定致病菌种。结果患者为17岁男性。9年前面部外伤后出现暗红色斑块和疣状增生至今,已扩散至左上臂。损害刮取物直接镜检见棕色分支分隔菌丝。标本培养有黑色菌落生长。镜检见棕色分支分隔菌丝和大量棒状、3～4个分隔的棕色孢子,单个或成群生于分生孢子梗的顶端和侧缘。组织病理显示为慢性肉芽肿。PAS染色见串珠状不规则膨大的菌丝。结论根据其形态学特点,菌种被确定为棒状弯孢。

Objective To report a case of subcutaneous phaeohyphomycosis caused by Curvularia clavata in China. Methods The skin specimen was collected, and examined by KOH preparation, fungus culture and histopathology. Results A 17-year-old male farmer had dull red, warty and well-defined plaques with some ulceration on his face and his left upper arm for nine years and a history of trauma of his face before the appearance of the lesions. General examination did not reveal abnormal findings except the skin lesions. KOH direct examination showed septate hyphae with irregular branches. On the culture medium the colonies were black in color. Under microscope the conidia were borne singly or in groups at the tip or at the sides of the conidiophores, they were light brown to brown, smooth, straight or slightly curved and clavate, measuring 15 ~ 30 μm long and 6 ~ 12 μm thick, with 3 ~ 4 septates. Histopathology showed a granulomatous response. PAS staining showed irregularly swollen or toruloid conidia with branched hyphae. The isolated strain was identified as Curvularia clavata Jain. Conclusion It is the first case report of subcutaneous phaeohyphomycosis caused by Curvularia clavata in China.