Primary deep cutaneous candidiasis caused by Candida duobushaemulonii in a 68-year-old man: the first case report and literature review
Primary deep cutaneous candidiasis caused by Candida duobushaemulonii in a 68-year-old man: the first case report and literature review
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DOI：
10.1111/myc.12540
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发表时间：
2016-12-01
期刊：
影响因子：
4.9
通讯作者：
Sun, Pei-Lun
中科院分区：
文献类型：
--
作者：
Fang, Szu-Yun;Wei, Kai-Che;Sun, Pei-Lun
皮肤的浅表念珠菌感染是常见的，但深部皮肤念珠菌病，包括继发性传播到皮肤的全身念珠菌病，念珠菌血症或原发性入侵由于皮肤缺损，如创伤，是罕见的。这些患者通常是免疫抑制，但免疫功能正常的宿主也会受到影响。白色念珠菌是最常见的病原体。然而，非白色念珠菌在极少数情况下可引起皮肤深部浸润。我们报告一位68岁男性罹患深部皮肤念珠菌病，经皮肤组织病理学检查证实为深部组织侵犯。最初使用VITEK（R）2系统进行微生物鉴定，将病原体鉴定为C.haemulonii，但后来基于核糖体DNA的内转录间隔区和26 S rDNA的D1/D2区的测序，确定为C.duobushaemulonii。患者成功地接受了阿替霉素B治疗，随后接受了氟康唑和手术干预。据我们所知，这是第一例深部皮肤感染的C. duobushaemulonii。
Superficial candida infections of the skin are common, but deep cutaneous candidiasis, including secondary dissemination to the skin from systemic candidiasis, candidaemia or primary invasion due to skin defects such as trauma, is rare. These patients are usually immunosuppressed, but immunocompetent hosts can be affected as well. Candida albicans is the most common pathogen. However, non-albicans Candida species can cause deep skin invasion in rare circumstances. We report a case of deep cutaneous candidiasis caused by Candida duobushaemulonii in a 68-year-old man. Deep tissue invasion was confirmed by skin histopathology examination. The pathogen was initially identified as C.haemulonii using the VITEK (R) 2 system for microbial identification, but was later determined to be C.duobushaemulonii based on sequencing of the internal transcribed spacer region of ribosomal DNA and D1/D2 region of 26S rDNA. The patient was successfully treated with amphotericin B, followed by fluconazole and surgical intervention. To the best of our knowledge, this is the first case of deep cutaneous infection by C.duobushaemulonii.