Abstract：
Corynespora cassiicola (C. cassiicola) is a common plant pathogen but occasionally causes infections in human skin. Poor outcome and death in such cases were then often reported even after a long course of antifungal treatment. In the present case, the patient was a 54-year-old farmer who presented with a ten-month history of an ulcerative lesion in the right lower extremity after a minor skin trauma. The patient had been undergoing immunosuppressive treatment for nephrotic syndrome for 2 months before the onset of the skin lesion. The fungal isolate from the lesion was identified as C. cassiicola by morphology and molecular sequencing. The patient was treated with ALA-PDT 5 times at 10 days intervals. The lesion disappeared and has not recurred in the 8-month follow-up. To our knowledge, it is the first time ALA-PDT has been used for treatment of a skin lesion caused by C. cassiicola. A retrospective analysis of the literature found 9 cases of C. cassiicola infection. All 9 patients had a history of immunodeficient conditions and had experienced a long course of antifungal therapy. Despite the rigorous antifungal treatment, 2 patients with CARD9 gene deficiency ultimately died. Our case suggests that photodynamic therapy is a potentially beneficial approach for treatment of fungal infection in immunosuppressed patients who failed to respond to antifungal agents.
摘要：
Corynesporacassiicola（C.cassiicola）是一种常见的植物病原体，但偶尔会引起人类皮肤感染。即使经过长时间的抗真菌治疗，这种情况下的不良结局和死亡也经常被报告。在目前的情况下,该患者是一名54岁的农民,在轻微皮肤创伤后,他有10个月的右下肢溃疡性病变病史.在皮肤病变发作之前，该患者已接受肾病综合征的免疫抑制治疗2个月。通过形态学和分子测序将来自病变的真菌分离物鉴定为C.cassiicola。患者以10天的间隔用ALA-PDT治疗5次。病灶消失，随访8个月未复发。据我们所知,这是ALA-PDT首次用于治疗由C.cassiicola引起的皮肤病变。回顾性分析文献发现9例念珠菌感染。所有9例患者均有免疫缺陷病史，并经历了长期的抗真菌治疗。尽管有严格的抗真菌治疗,2例患者CARD9基因缺乏终究逝世亡。我们的病例表明，光动力疗法是治疗对抗真菌药无效的免疫抑制患者真菌感染的潜在有益方法。
