Severe Disseminated Phaeohyphomycosis in an Immunocompetent Patient Caused by Veronaea botryosa
Severe Disseminated Phaeohyphomycosis in an Immunocompetent Patient Caused by Veronaea botryosa
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DOI：
10.1007/s11046-013-9632-5
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发表时间：
2013-06-01
期刊：
影响因子：
5.5
通讯作者：
Badali, Hamid
中科院分区：
文献类型：
--
作者：
Bonifaz, Alexandro;Davoudi, Mehrnaz Mohammad;Badali, Hamid
我们提出了一个严重的情况下，由于蔓延暗色丝孢真菌病的葡萄状婆婆纳。一名32岁女性，来自墨西哥莫雷洛斯的Cuautla，表现为10年前开始的慢性皮肤病，多发性外生、多小叶、柔软、有蒂或无柄的直径为2 - 10 cm的不同大小的新生物，变得疣状并增大。患者免疫功能正常，没有已知的遗传或熟悉的重要先例。没有给予治疗，皮肤病保持相对稳定，直到2001年和2003年患者怀孕。感染随后加重并恶化，导致扩散至四肢、躯干和面部。初步诊断为着色芽生菌病，用特比萘芬和伊曲康唑治疗，但无明显改善。组织学检查发现色素沉着、不规则、不分枝和有隔膜的菌丝。分离出葡萄孢婆婆纳菌（CBS 127264 = JX 566723），并通过对内部转录间隔区（ITS）rDNA进行测序来确认其身份。开始使用泊沙康唑（800 mg/天）治疗，显示病变逐渐改善，皮疹大小减小并变平。
We present a severe case of disseminated phaeohyphomycosis due to Veronaea botryosa. A 32-year-old female, native from Cuautla, Morelos, Mexico, presented a chronic dermatosis which started 10 years earlier with multiple exophytic, multilobulated, soft, and pedunculated or sessile neoformations of diverse sizes from 2 to 10 cm in diameter, which became verrucose and increased in size. The patient was immunocompetent, and no hereditary or familiar precedents of importance were known. No treatment was given, and the dermatosis remained relatively stable until the patient became pregnant in 2001 and 2003. The infection then exacerbated and worsened, leading to dissemination to the extremities, trunk, and face. The initial diagnosis was chromoblastomycosis which was treated with terbinafine and itraconazole but without visible improvement. Histopathology revealed pigmented, irregular, unbranched, and septate hyphae. Veronaea botryosa was isolated (CBS 127264 = JX566723), and its identity was confirmed by sequencing the internal transcribed spacer (ITS) rDNA. Therapy with posaconazole (800 mg/day) was started showing a gradual improvement of lesions with a reduction in size and flattening of the eruptions.