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着色芽生菌病

Chromoblastomycosis.

作者信息

Queiroz-Telles Flavio, de Hoog Sybren, Santos Daniel Wagner C L, Salgado Claudio Guedes, Vicente Vania Aparecida, Bonifaz Alexandro, Roilides Emmanuel, Xi Liyan, Azevedo Conceição de Maria Pedrozo E Silva, da Silva Moises Batista, Pana Zoe Dorothea, Colombo Arnaldo Lopes, Walsh Thomas J

机构信息

Department of Public Health, Hospital de Clínicas, Federal University of Paraná, Curitiba, Paraná, Brazil

CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands.

出版信息

Clin Microbiol Rev. 2017 Jan;30(1):233-276. doi: 10.1128/CMR.00032-16.

Abstract

Chromoblastomycosis (CBM), also known as chromomycosis, is one of the most prevalent implantation fungal infections, being the most common of the gamut of mycoses caused by melanized or brown-pigmented fungi. CBM is mainly a tropical or subtropical disease that may affect individuals with certain risk factors around the world. The following characteristics are associated with this disease: (i) traumatic inoculation by implantation from an environmental source, leading to an initial cutaneous lesion at the inoculation site; (ii) chronic and progressive cutaneous and subcutaneous tissular involvement associated with fibrotic and granulomatous reactions associated with microabscesses and often with tissue proliferation; (iii) a nonprotective T helper type 2 (Th2) immune response with ineffective humoral involvement; and (iv) the presence of muriform (sclerotic) cells embedded in the affected tissue. CBM lesions are clinically polymorphic and are commonly misdiagnosed as various other infectious and noninfectious diseases. In its more severe clinical forms, CBM may cause an incapacity for labor due to fibrotic sequelae and also due to a series of clinical complications, and if not recognized at an early stage, this disease can be refractory to antifungal therapy.

摘要

着色芽生菌病(CBM),也称为着色真菌病,是最常见的植入性真菌感染之一,是由黑色素化或棕色色素真菌引起的一系列真菌病中最常见的一种。CBM主要是一种热带或亚热带疾病,可能影响世界各地具有某些危险因素的个体。该疾病具有以下特征:(i)通过环境源植入进行创伤性接种,导致接种部位出现初始皮肤病变;(ii)慢性进行性皮肤和皮下组织受累,伴有与微脓肿相关的纤维化和肉芽肿反应,且常伴有组织增殖;(iii)2型辅助性T细胞(Th2)免疫反应无保护作用,体液参与无效;(iv)受影响组织中存在砖隔(硬化)细胞。CBM病变在临床上具有多形性,通常被误诊为各种其他感染性和非感染性疾病。在其更严重的临床形式中,CBM可能由于纤维化后遗症以及一系列临床并发症而导致劳动力丧失,如果不及早识别,这种疾病对抗真菌治疗可能无效。

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