PDF(Pubmed)
Abstract：
Chromoblastomycosis is an implantation mycosis of the skin caused by certain species of melanised fungi. A man in his 50s, born in Kerala but living in England for 14 years, presented with a nodular lesion on his left buttock, which had been present for 20 years. Biopsy revealed muriform cells and fungal culture isolated Fonsecaea spp, consistent with a diagnosis of chromoblastomycosis. Treatment with oral terbinafine was initiated and changed to itraconazole based on results of antifungal susceptibility. Drug intolerance and low drug levels of itraconazole necessitated change to voriconazole and topical terbinafine. Despite long-term combined therapy, the lesions worsened, and the patient opted for surgical excision abroad. Recurrence was evident at surgical sites and combined therapy continues. Chromoblastomycosis is an insidious and burdensome neglected tropical disease. Within non-endemic countries, diagnosis remains challenging. A travel history and appropriate fungal investigations are vital.
摘要：
成色真菌病是由某些种类的黑色素化真菌引起的皮肤植入性真菌病。一个50多岁的男人，出生于喀拉拉邦但在英国生活了14年,他的左臀部有结节性病变,已经存在了20年。活组织检查显示，分离的Fonsecaeaspp，与染色体成真菌病的诊断一致。开始口服特比萘芬治疗，并根据抗真菌药敏结果改为伊曲康唑。药物不耐受和伊曲康唑药物水平低，需要改用伏立康唑和外用特比萘芬。尽管长期联合治疗，病变恶化,患者选择在国外进行手术切除。手术部位复发明显，联合治疗仍在继续。染色体成真菌病是一种阴险而累赘的被忽视的热带病。在非流行国家，诊断仍然具有挑战性。旅行史和适当的真菌调查至关重要。
