Taxonomic analysis of cryptococcus species complex strain $8012 revealed Cryptococcus gattii with high heterogeneity on the ~enetics

Background Initially, Cryptococcus （C.） neoformans was previously divided into two varieties comprising C. neoformans var. neoformans and C. neoformans var. gattii. Currently, taxonomic studies defined C. neoformans as C. species complex, which contains C. neoformans var. neoformans （serotype D）, the hybrid isolates （serotype AD）, C. neoformans var. grubfi （serotype A） and C. gattii （serotypes B and C）. However, Liao and his team once isolated a unique C. gattii isolate, namely strain S8012 with unique phenotype from cerebrospinal fluid （CSF） of a 43-year-old male patient in the Shanghai Changzheng Hospital and described as C. neoformans var. shanghaiensis in 1980s. The aim of this study was to explore the genetic background and polymorphism of Chinese clinical C. gattii isolates. Methods S8012 was analyzed as representative strain using the M13-polymerase chain reaction （PC R） fingerprinting pattern and multilocus sequence analysis including internal transcribed spacers of rDNA （ITS region）, the intergenic spacer 1 regions （IGS1）, RPB1, RPB2, CNLACl, and TEF1 genes. Results The PCR fingerprinting pattern results showed strain S8012 belonged to molecular types VGI, and phylogenetic analysis suggested strain S8012 was grouped into the cluster of C. gattii environmental isolates originated from Eucalyptus camaldulensis trees in Australia. Conclusion C. gattii isolates from Chinese patients expresses high polymorphism on the phenotype, and molecular type VGI isolates from China have a close genetic relationship with the C. gattii isolates from Australia.

Disseminated herpes zoster in immunocompetent patients not due to varicella-zoster virus gene mutation

To the editor：varicella-zoster virus （VZV） exclusively infects humans,causing varicella and herpes zoster （HZ）.It is primary infection that varicella characteristically occurs early in life.However,VZV can reactivate,typically after the age of 50 years,to cause HZ.HZ is common due to a variety of factors such as age,fatigue,certain diseases and immunosuppressive therapy.Despite the chief reason that it has been reported also as immunocompromised states,disseminated herpes zoster （DHZ） with generalized eruption occurs only about 1% in HZ.1 Here we report two cases of DHZ in immunocompetent patients and a result of identification for VZV strain genotype.

Chinese Experts Consensus on Pre-examination and Triage in Dermatology Clinics during the COVID-19 Outbreak

The SARS-CoV-2 infection has brought a great challenge in prevention and control of the national epidemic of coronavirus disease 2019(COVID-19)in China.During the COVID-19 epidemic,properly carrying out pre-examination and triage for patients with skin lesions and fever has become a practical problem encountered in hospitals for skin diseases and dermatology clinics in general hospitals.Some of the carriers of the SARS-CoV-2 and patients with COVID-19 in the early stage may not present with any symptoms of COVID-19,while certain other skin diseases can also cause fever.Therefore,to properly deal with the patients presenting at dermatology clinics,the Chinese Society of Dermatology organized experts to formulate principles and procedures for the pre-examination and triage of patients at dermatology clinics during the COVID-19 epidemic.