星形奴卡菌性足菌肿1例

A Case of Mycetoma Caused by Nocardia Asteroids

患者女,40岁。左足背被田间竹枝戳伤后出现结节、肿块,部分破溃伴少量溢脓,逐渐加重8年。皮损组织病理示:真皮组织中见散在分布放射状结构的杵状体,周围有大量中性粒细胞、淋巴细胞及组织细胞浸润。深部组织真菌镜检和培养均(-),深部组织脓液培养见菌落生长,菌种鉴定为星形奴卡菌。诊断:星形奴卡菌性足菌肿。予复方磺胺甲恶唑、青霉素G和阿米卡星联合治疗,局部清创处理后好转。

A female,40-year-old, suffered from phymas,nodus, part of which was complicated with purulence on her left dorsum of foot for 8 years, after an external injury of the skin , and it gradually became worsening. Biopsy of lesions revealed that there appeared some radiational sulfur granules scattered in dermis, with large numbers of neutrophils, lymphocytes, and tissue cells around sulfur granules. Fungal culture and examination of deep lesions appeared negative ; bacterial culture of transudate from deep lesions showed nocardia asteroides occurred. This patient was diagnosed as mycetoma caused by Nocardia asteroides . The lesions were improved after the combined treatment of compound sulfamethoxazole, penicillin-G, amikacin and lesions debridement.