先天性皮膚念珠菌病：二病例報告

Congenital Cutaneous Candidiasis: Report of Two Cases

邱欽斌(Chin-Bin Chiou) ； 黃富源(Fu-Yuan Huang) ； 許瓊心(Chyong-Hsin Hsu) ； 洪漢陽(Han-Yang Hung) ； 陳秀琴(Shio-Chyn Chen)

《Acta Paediatrica Sinica》 31卷6期 (1990/12) Pp. 396-401

摘要

先天性皮膚念珠菌病，是一種極為罕見的疾病。本文報告二個新生兒，出生即發現有全身散在性的皮疹，為紅斑性丘疹、膿疱。分佈在頭部、臉部、頸部、軀幹、田肢。於病灶處做KOH抹片鏡檢發現有菌絲，而黴菌培養及組織切片證實為白色念珠菌感染。此為先天性的子宮內上行性感染。與新生兒念珠菌病……鵝口瘡，尿布疹有別。此疾在出生時或出生後12小時內即可看到疹子出現，為漸進性的紅斑性丘疹、膿疱，或有水疱出現。為散在性的全身分佈，尤其在皮膚對磨處、背部、四肢伸側可能受侵犯最嚴重。並無身體的其他症狀，亦無免疫方面的缺陷。由臨床的症狀，KOH的抹片鏡檢，或黴菌的培養可以和新生兒期的其他皮膚疾病做一鑑別診斷。如無全身性黴菌的感染，只需給予局部抗黴菌藥物塗抹，症狀即改善併痊癒，其預後相當好。

並列摘要

Congenital cutaneous candidiasis is a very rare disease. We reported two newborn infants in whom generalized skin eruption was noted at birth, characteristics of erythematous papules and pustules. The eruption involved head, face, neck, trunk and extremities. Candida albicans was demonstrated on direct KOH smear, by surface fungal cultures and skin biopsy. The disease implies a congenital intrauterine infection and is different from neonatal candidiasis which manifests as thrush, diaper dermatitis. The route of infection is ascending in congenital cutaneous candidiasis. The skin eruption is usually noted at birth or within 12 hours after delivery as a diffuse erythematous maculopapula, with pustules or vesicles distributed over head, face, neck, trunk and extremities. There is no fever; other constitional signs are lacking. No evidence of impaired immunological responsiveness has been noted in preveious study. Clinical features, direct smear examination of specimen and appropriate cultures are useful in differentiating the lesions from other more common dermatoses of the neonatal period. Topical antifungal therapy is sufficient unless systemic candidiasis is present. Prognosis for congenital cutaneous candidiasis is good.

並列關鍵字

congenital cutaneous candidiasis