从一例甲真菌病患者病甲中分离出糠秕孢子菌临床和实验研究.doc

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1、从一例甲真菌病患者病甲中分离出糠枇砲子菌临床和实验研究中华皮肤科杂志1998年第5期第31卷论著作者：冉玉平周光平李薇彭雪梅杜晓平刘徳操单位:610041成都，华西医科大学附属第一医院皮脐性病科（冉玉平周光平李薇杜晓平刘徳操）；法医系电镜室（彭雪梅）关键词：甲真菌病；卵形糠粧泡子菌；红色毛癣菌；显微镜，电子【摘要】从一例甲真菌病患者的病甲标本中分离出糠楸抱子菌，并进行了培养、组织病理、打描电镜、溶甲等研究。患者为64岁女性，因指趾甲变色、增厚、粗糙20余年就诊。体检见各指、趾甲増厚变色，表面粗糙不平

2、，指甲前端甲板与甲床分离。指甲培养结果发现在沙堡培养基有红色毛癣菌生长，在含菜子油培养基有卵形糠枇泡子菌生长。病理检杏发现甲纽•织裂隙中有卵形出芽泡子，扫描电镜观察见大量有颈圈样结构的卵形出芽泡子镶嵌于甲纽织中。20%KOH、56°C处理1小时的甲沉淀物涂片经Parker墨水染色后镜下可见与卵形糠枇砲子菌和红色毛癣菌形态一致的泡子和菌丝。患者接受伊曲康卩坐间歇冲击治疗，第四疗程结束后I〜2月时甲颜色明显光亮，以后未见进一步好转。治疗结束后6个月时再剪病甲培养乂有红色毛癣菌和卵形糠枇袒子菌生长。结论此

3、为国内首次报道卵形糠枇砲子菌与甲真菌病有关。复习文献，对红色毛癣菌和卵形糠枇砲子菌在发病中的地位进行了讨论。IsolationofPityrosporumovalefromaPatientwithOnychomycosis:ClinicalandLaboratoryInvestigationRanYuping:fZhouGuangping,LiWei,etal.*DepartmentofDermatovenereology,FirstUniversityHospital,WestChinaUniv

4、ersityofMedicalSciences,Chengdu610041［Abstract］ObjectiveToisolateandobservePityrosporumyeastsfromapatientwithonychomycosis.MethodsTheinvolvednailspecimenswereinvestigatedbymeansofculture,pathologicalandscanningelectronmicroscopicexaminationand20%KOHpre

5、paration.ResultsPhysicalexaminationshowedthateachfingerandtoenailappearedbrownish-black,roughandthick,someoftheforepartofthenailplatedetachedfromthenailbed・Fingernailspecimen'scultureresultsshowedthatTrichophytonrubrumgrewonSabouraud'sdextros

6、eagarandPityrosporumovalegrewonthemediumcontainingrapeseedoil.ThepathologicalexaminationrevealedP.ovaleyeastinvolvementinthefissureofthenailplate.Underthescanningelectronmicroscopy,alotofP.ovaleyeastswithcharacteristiccollarettestructureinsertedinthena

7、iltissuewasnoticed.Inthe20%KOHpreparationsofnailincubatedat56°CforlhandstainedwithQuinkParkerink,sporesandhyphaewereidentifiedmoiphologicallywithP.ovaleandT.rubrumrespectively.Thepatientreceivedinterniittentpulsetherapywithitraconazole,thecolorofthenai

8、lsbecamemuchbrighter1to2monthsafterthefourthcycleoftherapy,butnofurtherimprovementwasobservedafterwards.P.ovaleandT.rubrumgrewagain6monthsaftertreatmentwhentheclippingsofthefingernailwerecultured.ConclusionThisisthefirstdocumentofonycho