PDF(Pubmed)
Abstract：
Blastomycosis is a dimorphic fungus caused by the species of Blastomyces dermatitidisand Blastomyces gilchristii, which are endemic to the Ohio River and Mississippi River Valleys. It is commonly found in soil or decomposing wood. It is capable of infecting both immunocompromised and immunocompetent patients via the respiratory tract by inhaling conidia, where it may remain asymptomatic for a prolonged period of time. Extrapulmonary complications can occur in disseminated disease due to haematogenous spread from the lungs to other organ systems. Haematogenous dissemination from the lungs occurs most commonly to the skin. Although rare, primary cutaneous blastomycosis can also occur with direct inoculation through the trauma of the skin. Patients presenting with cutaneous blastomycosis are often misdiagnosed with malignant neoplasms and may not be appropriately managed until further testing and tissue biopsy. Currently, there are only four previous case reports of blastomycosis presenting in the intranasal region. We report two cases of cutaneous blastomycosis of the nasal passages and upper lip with pulmonary manifestations in Southern West Virginia. These patients first presented with cutaneous symptoms, which were originally treated for melanoma and squamous cell carcinoma and were later diagnosed with systemic blastomycosis.
摘要：
胚芽真菌病是由皮肤胚芽和gilchristii胚芽引起的双态真菌，是俄亥俄河和密西西比河山谷特有的。它常见于土壤或分解木材中。它能够通过吸入分生孢子通过呼吸道感染免疫功能低下和免疫功能正常的患者，它可能在很长一段时间内保持无症状。由于从肺部向其他器官系统的血源性扩散，播散性疾病可能发生肺外并发症。从肺的血源性播散最常见于皮肤。虽然罕见，原发性皮肤芽真菌病也可以通过皮肤创伤直接接种而发生。表现为皮肤芽生菌病的患者通常被误诊为恶性肿瘤，直到进一步检查和组织活检才可能得到适当的治疗。目前,以前只有四例在鼻内区域出现芽生菌病的病例报告。我们报告了西弗吉尼亚州南部的2例鼻腔和上唇皮肤芽生菌病并伴有肺部表现。这些患者首先出现皮肤症状，最初治疗黑色素瘤和鳞状细胞癌，后来被诊断为全身性胚真菌病。
