国内首例阴囊伪膜样星形毛孢子菌感染

摘要

Objective To report a case of scrotal trichosporonosis presenting with powdery and pseudomembraneous lesions on the scrotum in an immunocompetent patient.Methods A 25-year-old man complained of white crust on the scrotum for 6 weeks.We confirmed the diagnosis by KOH mount of the skin scrapings,fungal culture,CHROM agar culture,urease test,cycloheximide and molecular verification.Results KOH mount of the skin scrapings was positive for septate hyphae.Trichosporon asteroides was isolated from the lesions and confirmed by morphological and molecular analysis,a basidiomycetous yeast showing meristematic as well as hyphal growth with arthroconidia.The isolate colonies were blue in color on CHROM agar Candida agar.The urease test was positive,and the isolate was resistant to cycloheximide.The patient responded well to the use of oral and topical terbinafine,and his lesions cleared completely after two weeks.Conclusions Scrotal trichosporonosis due to Trichosporon asteroids was rarely reported in clinic,study on this case will assist in diagnosis and treatment of cu taneouse trichosporonosis.%目的 报道1例由星形毛孢子菌感染引起的伪膜样阴囊感染.方法 患者,男,25岁,阴囊白色膜样附着物6周.通过对患者皮损进行真菌镜检、真菌培养,并对获得菌株进行科玛嘉显色培养基鉴定、尿素酶试验、放线菌酮耐受试验和分子生物学分析等实验研究.结果 皮损真菌镜检可见大量透明分隔菌丝,真菌培养和分子生物学鉴定为星形毛孢子菌.小培养镜下不但见典型关节菌丝还见典型的多分生细胞.该临床菌株在科玛嘉显色培养基上呈淡蓝色菌落,尿素酶试验阳性,对放线菌酮不敏感.患者口服特比萘芬和外用特比萘芬乳膏,连续2周.停药时皮损消退,真菌学检查阴性.结论 由星形毛孢子菌感染引起的伪膜样阴囊感染临床罕见报道,通过对该病例的深入研究,为临床诊疗提供参考依据.