Congenital Candidal Onychomycosis-A Case Report

甲癬佔所有指甲疾病的百分之四十。它大多發生在成人，而少見於小孩。白色念珠菌雖然在很多培養場合可看見，但真正證實是甲癬的致病菌則很少見。我們報告一位男嬰於一週大開始出現先天性甲癬。男嬰為33歲的健康母親（孕次2胎次2）懷孕36週後經產道生產。母親於生產前曾有陰道分泌物增加的現象，其細菌培養出現酵母菌狀的微生物。身體檢查發現男嬰的身上並沒有黏膜或是皮膚念珠菌病。而手指甲及腳趾甲出現變黃變厚的現象，並且合併指甲周圍發炎。KOH檢查發現大量的假菌絲在指甲組織內。黴菌培養証實為白色念珠菌。組織病理檢查，發現剪除的指甲在PAS染色下出現菌絲結構。此外，我們使用PCR放大菌株之內轉錄區(internal transcribed spacer)，PCR產物只會與固定在晶片上檢測多種酵母菌及皮癬菌的寡核甘酸探針中的白色念珠菌探針產生雜合反應，進一步証實了白色念珠菌的存在。病人經過兩個月局部sulconazole nitrate 1%的治療之後，指甲的症狀完全痊癒。

關鍵字

無資料

並列摘要

Onychomycosis represents 40% of all nail disorders. It is commonly observed in adults but rarely in children. Candida species, although frequently isolated in many occasions, are rarely proved to be the causative agent in the disease. Here we present a male infant who presented with congenital candidal onychomycosis since 1 week of age. He was born to a 33-year-old healthy woman (gravida 2 para 2) via normal vaginal delivery at 36th week of gestation. Before childbirth, the mother had a history of vaginal discharge, from which the bacterial culture showed yeast-like microorganism in moderate amount. On examination, the neonate had no evidence of mucosal and cutaneous candidiasis except yellowish discoloration and thickening of the fingernails and toenails with inflammation of the periungual area. The KOH preparation from nails revealed a large number of pseudohyphae. The fungal culture revealed the presence of Candida albicans. Histopathologically, the nail clipping showed numerous PAS-positive hyphal elements. In addition, ribosomal internal transcribed spacer (ITS) amplified by PCR from nail clippings hybridized only with Candida albicans-specific oligonucleotide probe immobilized on a DNA chip which contained an array of oligonucleotides of detection of yeasts and dermatophytes. The patient received topical sulconazole nitrate 1% solution for 2 months, which led to cure of infected fingernails.

並列關鍵字

Congenital candidal onychomycosis ； Candida albicans

國際替代計量

Congenital Candidal Onychomycosis-A Case Report

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