Sheila Requena López , Patricia Morales del Burgo , Santiago Gómez Díez , Jose Antonio Boga , Teresa Peláez García de la Rasilla
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引用次数: 0
Abstract
Background
Curvularia is a filamentous dematiaceous fungus increasingly recognized as a pathogen in immunocompromised patients. The most common clinical entities associated with this fungus are allergic sinusitis, cutaneous infection and keratitis. In this article, a report on the first clinical case of Curvularia pallescens cutaneous infection in Spain and its treatment is described.
Case report
A 68 year-old man with a history of lung transplantation presented to Dermatology Unit due to a skin lesion in the knee that had been evolving for 6 months. A skin biopsy was performed for its study. In the histopathological study, an intense and non-specific inflammatory reaction in the dermis was observed, and with Grocott stain and periodic acid Schiff abundant septate hyphae and spores were found in the dermis. The culture of the sample revealed a filamentous fungus whose microscopic examination allowed to identify the genus as Curvularia. Using MALDI-TOF mass spectrometry and molecular identification, the fungus was finally identified as Curvularia pallescens. The patient underwent surgical resection of the lesion and was treated with posaconazole, evolving favorably.
Conclusions
The species of Curvularia should be considered causal agents of fungal skin infections in immunosuppressed patients. This clinical case, which showed good clinical response after surgical resection and treatment with posaconazole, is the first described in Spain due to this species.
曲霉菌是一种丝状真菌,越来越被认为是免疫功能低下患者的病原体。与这种真菌相关的最常见的临床实体是过敏性鼻窦炎,皮肤感染和角膜炎。本文报道西班牙首例白曲霉皮肤感染的临床病例及其治疗方法。病例报告:一名68岁男性,有肺移植史,因膝盖皮肤病变持续6个月而就诊于皮肤科。对其进行了皮肤活检。在组织病理学检查中,观察到真皮强烈的非特异性炎症反应,Grocott染色和周期性酸希夫染色发现真皮内有丰富的分隔菌丝和孢子。样品的培养发现了一种丝状真菌,其显微镜检查允许确定属曲霉。通过MALDI-TOF质谱分析和分子鉴定,最终鉴定该真菌为曲霉(Curvularia pale cens)。患者接受手术切除病变并给予泊沙康唑治疗,进展良好。结论曲霉属应被认为是免疫抑制患者皮肤真菌感染的病因。该病例在手术切除并应用泊沙康唑治疗后表现出良好的临床反应,是西班牙首例因该物种引起的病例。
期刊介绍:
Revista Iberoamericana de Micología (Ibero-American Journal of Mycology) is the official journal of the Asociación Española de Micología, Asociación Venezolana de Micología and Asociación Argentina de Micología (The Spanish, Venezuelan, and Argentinian Mycology Associations). The Journal gives priority to publishing articles on studies associated with fungi and their pathogenic action on humans and animals, as well as any scientific studies on any aspect of mycology. The Journal also publishes, in Spanish and in English, original articles, reviews, mycology forums, editorials, special articles, notes, and letters to the editor, that have previously gone through a scientific peer review process.