铁锈色小孢子菌引起Majocchi肉芽肿1例临床分析及分子鉴定

One case report of Majocchi granuloma caused by M. ferrugineum:clinical and molecular

目的报道1例铁锈色小孢子菌感染引起的结节性肉芽肿及病理改变,探讨诊断和治疗。方法反复取感染部位分泌物进行细菌和真菌培养,对皮损进行病理检查,将培养菌落进行rDNAITS测序鉴定。结果分泌物PDA培养基中可见灰色菌落,表面呈绒毛状,37℃生长良好,镜下可见分隔菌丝未见分生孢子。分子生物学ITS测序结果显示:病原菌与铁锈色小孢子菌相似率为100%。确诊后用伊曲康唑治疗取得良好效果。结论在新疆特别是南疆地区头癣是很常见的皮肤病。对皮肤出现结节性损害且长期抗炎治疗不愈的患者,要考虑真菌感染的可能,及时诊断并早期进行抗真菌治疗。

Objective To report the pathological changes in one case of nodular granuloma caused by M.ferrugineum , and to study the diagnosis and treatment. Methods Secretion was withdrawn repeatedly from infected sites for both bacterial and fungal cultivation. PCR （rDNA ITS sequence analysis）was performed for diagnosis and early treatment. Results Grey colony grew on PDA culture medium with villiform surface at 37℃. Separate myeelinm were found under microscope without conidiospore. ITS results showed the pathogen had 100% similarity to M.ferrugineum. hraconozole appeared to have satisfactory therapeutic efficacy. Conclusions Tinea capitis is common in Xinjiang especially in the Southern area. Fungal infection should be considered in those patients who are ineffective to long-term antibiotic treatment with nodules in skin.