以疣状结节为特征的近平滑念珠菌病二例

Candida parapsilosis-c aused candidiasis characterized by verrucous nodules： two case reports

目的 报告2例以疣状结节、肿块为特征的近平滑念珠菌病,分析其临床特征、探讨诊治方法.方法 仔细询问病史、了解用药史及疗效,体检时重点检查皮损和真菌学检查,结合组织病理学而确诊.及时给予足量的抗真菌药物,见效后渐减量,直至痊愈才停药.早期外用含糖皮质激素的抗真菌制剂等治疗.结果 2例确诊为以疣状结节肿块为特征的平滑念珠菌病.经服伊曲康唑等治疗及支持治疗100 d痊愈.结论 坚持以抗真菌为主的综合治疗,抗真菌药物要早期、足量、足疗程,以达满意疗效.

Objective To report two cases of Candida parapsilosis-caused candidiasis characterized by verrucous nodules and masses,and to assess their clinical features,diagnosis and treatment.Methods A medical history including medication history and therapeutic response was carefully collected from two male patients.Physical examination was carried out with a focus on skin lesions.Diagnosis was made according to medical history as well as physical,mycological and histopathological examination findings.Antifungal agents were given at a high enough dose in time.After lesions improved,the doses of antifungal agents were tapered gradually,and drugs were withdrawn until patients completely healed.Compound preparations containing both antifungal agents and glucocorticoids were also topically applied in the early period of treatment.Results Both patients were diagnosed as Candida parapsilosis-caused candidiasis characterized by verrucous nodules and masses,and cured after 100-day supporting treatment and antifungal treatment with oral itraconazole,etc.Conclusions Candida parapsilosis-caused candidiasis should be managed with combination therapy mainly including antifungal agents.To achieve a satisfying efficacy,antifungal agents should be given early at a high enough dose for a long enough period.