- 期刊
Coexisting Chromoblastomycosis and Mycobacterium fortuitum Skin and Subcutaneous Infection
在一位糖尿病人身上同時存在的產色黴菌病和偶發分枝桿菌的皮膚和皮下感染
摘要
這篇是報告在一位糖尿病人身上同時發病的皮膚和皮下產色黴菌病和偶發分枝桿菌感染的個案。光用傷口培養的方式很難去診斷這些感染。必需積極的做皮膚切片才能去發現和診斷產色黴菌病、偶發分枝桿菌所引發的感染。我們爲這位病人做了重覆的傷口切片和組織培養，右手的切片培養出產色黴菌而左手的傷。切片培養出偶發分枝桿菌。一般建議的治療方式是外科切除或用液態氮的冷凍療法來治療小範圍的產色黴菌病但我們是用itraconazole每天200毫克持續六個月的治療，左手傷口偶發分枝桿菌所引發的感染則是用八個月的levofloxacin和clarithromycin合併治療及七個月的amikacin肌肉注射治療，這些傷口最後痊癒而只留下色素沉著的後遺症。治療時間的長短必需依據臨床的反應和黴菌學及組織病理學上的痊癒。
關鍵字
無資料並列摘要
We report a diabetic patient with coexisting skin and subcutaneous infection of chromoblastomycosis and Mycobacterium fortuitum. Cultures of these skin lesions or discharges frequently fail to demonstrate these organisms. Aggressive skin biopsy revealed finding and diagnosis of chromoblastomycosis and Mycobacterium fortuitum. We performed repeat skin biopsies and tissue cultures for this patient. The culture of right arm yielded Fonsecaea pedrosoi and the culture of left arm yielded Mycobacterium fortuitum. Preferred treatment is usually surgical excision or cryosurgery with liquid nitrogen for small lesions of chromoblastomycosis but we administered itraconazole 200 mg per day for 6 months and the lesions completely recovered with only the sequelae of pigmentation. The Mycobacterium fortuitum infection of left arm was cured with 8-month combination therapy of levofloxacin, clarithromycin, and 7-month treatment of amikacin. Duration of treatment depends on the clinical response and achievement of mycologic and histopathological cure.