真菌荧光染色直接镜检对无绿藻致手部感染的早期诊断价值

The early diagnostic value of fungal fluorescence staining for hand infections caused by Prototheca

目的探讨真菌荧光染色直接镜检对无绿藻致手部感染的早期诊断价值。方法报道我院2024年1月发现的1例小型无绿藻致手部感染病例的检查过程,并回顾既往文献22例无绿藻致手部感染病例。结果连同本文报道1例,共分析23例无绿藻致手部感染的病例,真菌培养和组织病理检查是主要的实验室检查方法。23例患者中,只有8例标本同时直接涂片镜检,其中4例观察到无绿藻的特征形态,另外4例为阴性。通过真菌荧光染色直接镜检观察到无绿藻的有2例,其特征性的内孢子结构清晰,呈车轮状或山竹样排列。结论标本真菌荧光染色直接镜检灵敏度高,能快速识别无绿藻的特征性内孢子,有助于无绿藻致手部感染的早期诊断,值得临床推广。

Objective To evaluate the early diagnostic value of fungal fluorescence staining for hand infections caused by Prototheca.Methods The examination process of a case of hand infection caused by Prototheca wickerhamii in our hospital in January 2024 was reported,and 22 previous literature cases of hand infection caused by Prototheca were reviewed.Results A total of 23 cases of hand infection caused by Prototheca were analyzed.Fungal culture and histopathological examination were the main laboratory examination methods.Only 8 specimens were directly smeared for microscopic examination at the same time.Among them,4 cases observed characteristic morphology of Prototheca,while the other 4 cases were negative.Two cases of Prototheca were directly observed through fungal fluorescence staining.Its characteristic endospore structure is clear and arranged in a wheel shaped or mangosteen like pattern.Conclusion Direct microscopy with fungal fluorescence staining of specimens has high sensitivity and can quickly identify characteristic endospores of Prototheca,which is helpful for early diagnosis of hand infections caused by Prototheca and is worthy of clinical promotion.