■出芽梭菌是一种脱脂性的,酵母样真菌,在自然界中无处不在,可以定植于人类的头发和皮肤。它在临床上被认为会引起皮肤和软组织感染,脑膜炎,脾脓肿和腹膜炎。我们呈现,根据我们的知识,在一名艾滋病患者中分离这种生物的第二例,以及对人类感染普鲁兰杆菌的文献的回顾。
■一名49岁的患有晚期艾滋病并有食道念珠菌病复发史的男子因恶心呕吐入院,和吞咽困难.他被治疗为食管念珠菌病复发。鉴于先前的白色念珠菌分离敏感性和氟康唑的慢性抑制,他开始服用米卡芬净,症状最终得到改善。最初据报道,入院时的血培养阳性是酵母生长,但是四天后,该分离株被认为是一种毛质真菌。直到入院后1个月才能最终鉴定出普鲁兰。在鉴定分离株之前,他已经完成了为期3周的米卡芬净疗程,重复培养是阴性的。
■A.普鲁兰菌血症很少见,但可发生在免疫抑制或留置导管的患者中。从血液培养物中分离普鲁兰杆菌在其是否是疾病状态的病原体方面的重要性通常不能确定,因为皮肤定植是可能的。需要进一步的工作来阐明普鲁兰真菌血症的临床意义。
UNASSIGNED: Aureobasidium pullulans is a dematiaceous, yeast-like fungus that is ubiquitous in nature and can colonize human hair and skin. It has been implicated clinically as causing skin and soft tissue infections, meningitis, splenic abscesses and peritonitis. We present, to our knowledge, the second
case of isolation of this organism in a patient with AIDS along with a review of the literature on human infection with A. pullulans.
UNASSIGNED: A 49-year-old man with advanced AIDS and a history of recurrent oesophageal candidiasis was admitted with nausea with vomiting, and odynophagia. He was treated as having a recurrence of oesophageal candidiasis. Given prior Candida albicans isolate susceptibilities and chronic suppression with fluconazole, he was started on micafungin with eventual improvement in his symptoms. A positive blood culture from admission was initially reported to be growing yeast, but four days later the isolate was recognized as a dematiaceous fungus. The final identification of A. pullulans was not available until 1 month after admission. He had completed a 3-week course of micafungin prior to the identification of the isolate, and repeat cultures were negative.
UNASSIGNED: A. pullulans fungemia is rare but can occur in patients with immune suppression or indwelling catheters. The significance of isolating A. pullulans from a blood culture in terms of whether it is the causative agent of a state of disease often cannot be determined because skin colonization is possible. Further work is needed to clarify the clinical implications of A. pullulans fungemia.