背景:链格孢菌是一种能够引起多种感染的黑色素真菌,其中一些具有致命潜力。它是一种普遍存在的真菌和众所周知的植物病原体。Alternariaalternata的皮肤感染最常见于进行常规农业的患者的四肢,从而暴露于职业危害,导致皮肤屏障的破坏。
方法:本文介绍了第一例来自罗马尼亚的伊曲康唑无反应性皮肤交替增多症患者,没有任何类型的免疫抑制。
结果:在对患者皮肤感染的病因进行初步误诊后,连续两次穿刺活检,接着是真菌学检查,导致最终诊断为皮肤交替病。以抗真菌药敏试验为指导的治疗已经开始,导致患者皮肤溃疡逐渐愈合。
结论:链格孢菌感染有免疫能力的人宿主并对抗真菌药物产生耐药性的能力突出了正确诊断皮肤溃疡的病因并在抗真菌药敏试验指导下制定适当治疗方法的重要性。
BACKGROUND: Alternaria alternata is a melanic fungus capable of causing a wide variety of infections, some of which have lethal potential. It is a ubiquitous fungus and a well-known plant pathogen. Cutaneous infections with Alternaria alternata most often occur in the extremities of patients who perform conventional agriculture, thus being exposed to occupational hazards leading to the disruption of the skin barrier.
METHODS: This paper presents the first
case report from Romania of an itraconazole nonresponsive cutaneous alternariosis in a patient without any type of immunosuppression.
RESULTS: After an initial misdiagnosis regarding the etiology of the patient\'s skin infection, two successive punch biopsies, followed by mycologic examination, lead to the final diagnosis of cutaneous alternariosis. Treatment guided by antifungal susceptibility testing has been instituted, leading to the gradual healing of the patient\'s skin ulcerations.
CONCLUSIONS: The ability of Alternaria alternata to infect immunocompetent human hosts and to develop resistance to antifungal drugs highlight the importance of correctly diagnosing the etiology of skin ulcerations and instituting appropriate treatment guided by antifungal susceptibility testing whenever the suspicion of a fungal skin infection is plausible.