PDF(Pubmed)
Abstract：
OBJECTIVE: To document a case of lobomycosis and to discuss its epidemiology & diagnosis.
METHODS: A 53-year-old male presented with a history of nasal congestion, nasal discharge, and epistaxis following Covid 19 infection. On physical examination, there was necrotic slough in the nasal vestibule near the inferior turbinate. Scrapings and punch biopsy were taken from the lesion. Hematoxylin-eosin-stained sections showed necrotic and mucoid areas with mixed inflammatory cell infiltration and numerous budding yeasts 3- 7μm diameter in singles, and small clusters with single narrow based budding as well as multiple budding including sequential budding forming \"chains of yeasts\". A diagnosis of Lobomycosis was made. Yeasts of lobomycosis are often confused with other yeasts such as P. brasiliensis, Candida spp., B. dermatitidis, and Cryptococci, but characteristic \'sequential budding\' with a \'chain of yeasts\" aid in the final diagnosis. Demonstration of yeasts with characteristic chains either in tissue sections or in potassium hydroxide (KOH) preparation of scraped material, exudate, or exfoliative cytology is the mainstay in the diagnosis as the organisms are uncultivable in vitro in culture medium.
METHODS: A 53-year-old male presented with a history of nasal congestion, nasal discharge, and epistaxis following Covid 19 infection. On physical examination, there was necrotic slough in the nasal vestibule near the inferior turbinate. Scrapings and punch biopsy were taken from the lesion. Hematoxylin-eosin-stained sections showed necrotic and mucoid areas with mixed inflammatory cell infiltration and numerous budding yeasts 3- 7μm diameter in singles, and small clusters with single narrow based budding as well as multiple budding including sequential budding forming \"chains of yeasts\". A diagnosis of Lobomycosis was made. Yeasts of lobomycosis are often confused with other yeasts such as P. brasiliensis, Candida spp., B. dermatitidis, and Cryptococci, but characteristic \'sequential budding\' with a \'chain of yeasts\" aid in the final diagnosis. Demonstration of yeasts with characteristic chains either in tissue sections or in potassium hydroxide (KOH) preparation of scraped material, exudate, or exfoliative cytology is the mainstay in the diagnosis as the organisms are uncultivable in vitro in culture medium.
摘要：
目的：记录1例叶真菌病病例，探讨其流行病学和诊断。
方法：一名53岁男性，有鼻塞史，鼻腔分泌物,新冠肺炎感染后的鼻出血。在体检时，下鼻甲附近的鼻前庭有坏死的淤泥。从病变处取得刮痕和穿刺活检。苏木精-伊红染色切片显示坏死和粘液样区域混合炎症细胞浸润和许多出芽酵母3-7μm直径，和具有单个窄基出芽以及多个出芽的小簇，包括顺序出芽形成“酵母链”。诊断为白霉菌病。小叶真菌病的酵母经常与其他酵母混淆，例如巴西酵母，念珠菌属。,B.dermatitidis，和隐球菌,但特征性的“顺序萌芽”与“酵母链”有助于最终诊断。在组织切片或氢氧化钾（KOH）制备刮片材料中演示具有特征链的酵母，渗出物,或脱落细胞学是诊断的主要手段，因为生物体在培养基中无法在体外培养。
方法：一名53岁男性，有鼻塞史，鼻腔分泌物,新冠肺炎感染后的鼻出血。在体检时，下鼻甲附近的鼻前庭有坏死的淤泥。从病变处取得刮痕和穿刺活检。苏木精-伊红染色切片显示坏死和粘液样区域混合炎症细胞浸润和许多出芽酵母3-7μm直径，和具有单个窄基出芽以及多个出芽的小簇，包括顺序出芽形成“酵母链”。诊断为白霉菌病。小叶真菌病的酵母经常与其他酵母混淆，例如巴西酵母，念珠菌属。,B.dermatitidis，和隐球菌,但特征性的“顺序萌芽”与“酵母链”有助于最终诊断。在组织切片或氢氧化钾（KOH）制备刮片材料中演示具有特征链的酵母，渗出物,或脱落细胞学是诊断的主要手段，因为生物体在培养基中无法在体外培养。
