Objective To understand the pathogens of tinea capitis during the period 1960-2015.Methods Fungal strains isolated from the patients with tinea capitis in the Medical Mycology Clinical Laboratory were subjected to a classification and statistical analysis.Morphological,physiological and biochemical methods were applied for fungal identification.Results Tinea capitis prevalence was high in the 1960s,with Trichophyton violaceum (41.9 ％) and Trichophyton schoenleinii (31.0 ％) being the most common pathogenic species,while the cases decreased sharply in the 1970s.Later in the 1990s,the proportion of Microsporum canis dropped to 1％ after its peak (36.9 ％).T.violaceum had replaced T.schoenleinii and become the most common species (63 ％).T.schoenleinii and Trichoph yton rubrum tended to infect adults,while T.violaceum,M.canis,Trichophyton interdigitale and Microsporum ferrugineum were more likely to infected children.The proportion of female patients among adults (64.6％) was higher than that of children (50.6％) (T.schoenleinii excluded) (P＜0.05).Conclusion The pathogens of tinea capitis changed over time and now T.violaceum had become the most common species in the district.

Objective Understanding colonization or infection of Scedosporium in lower respiratory tract of secondary pulmonary tuberculosis.Methods Major pathogens of Scedosporiosis,5 Scedosporium spp.(S.apiospermum,S.boydii,S.minutispora,S.aurantiacum and S.dehoogii),were detected in bronchoalveolar lavage fluid from the patients with secondary pulmonary tuberculosis using direct microscope examination,fungal culturing and PCR-based reverse line blot (PCR-RLB) targeting the partial β-tubulin gene.Result No Scedosporium spp.were found in 101 specimens of bronchoalveolar lavage fluid from secondary pulmonary tuberculosis patients.Conclusion Rare Scedosporium spp.colonize or infect in lower respiratory tract of secondary pulmonary tuberculosis.It implies that secondary pulmonary tuberculosis complicated by Scedosporiosis due to increasing colonization of Scedosporium spp.in the respiratory tract will be uncommon.

Objective To report two cases of Candida parapsilosis-caused candidiasis characterized by verrucous nodules and masses,and to assess their clinical features,diagnosis and treatment.Methods A medical history including medication history and therapeutic response was carefully collected from two male patients.Physical examination was carried out with a focus on skin lesions.Diagnosis was made according to medical history as well as physical,mycological and histopathological examination findings.Antifungal agents were given at a high enough dose in time.After lesions improved,the doses of antifungal agents were tapered gradually,and drugs were withdrawn until patients completely healed.Compound preparations containing both antifungal agents and glucocorticoids were also topically applied in the early period of treatment.Results Both patients were diagnosed as Candida parapsilosis-caused candidiasis characterized by verrucous nodules and masses,and cured after 100-day supporting treatment and antifungal treatment with oral itraconazole,etc.Conclusions Candida parapsilosis-caused candidiasis should be managed with combination therapy mainly including antifungal agents.To achieve a satisfying efficacy,antifungal agents should be given early at a high enough dose for a long enough period.

Objective To investigate the sterilization effect of Atmospheric pressure non-equilibrium plasma(APNP) to Candida albicans and its mechanisms.Methods Standard strains of Candida albicans were treated with APNP with different gas flows,operation durations and distances.Growth of the strains was observed,CFU was calculated with plate counting method and the changes of cell structure were observed with electron microscope.Results The growth of Candida albicans strains was suppressed significantly after treated with APNP.The inhibitory effect was greater with the gas flow of 2 /0.06 L / min(He / O2) than with that of 2 /0.02 L / min,the operation duration of 10 min was better than 2 min,and the distance of 1 cm was better than 2 cm.After exposure to APNP,the fungal cells showed wizened,broken cell wall and cell membrane,leakage of cell content under electron microscopes.Conclusions The sterilization effect of APNP on Candida albicans is significant.This effect is promoted with more O2,longer operation duration and nearer distance.The main mechanism may be attributed to the active particles,which cause the breaking of the cell wall and membrane.

<正>头癣是由皮肤癣菌感染头皮及头发所致的传染性疾病。根据致病菌种和宿主反应及临床表现的不同,分为白癣、黑点癣、脓癣及黄癣。近30 a来,城乡人口大量频繁流动、城市宠物盛行,使亲动物性皮肤癣菌感染增多,特别是脓癣的发病率逐年

患者男,17岁.因双大趾甲板变形、渐累及其他趾甲7年,双小腿、上臂、上胸背部相继发生结节、水疱、糜烂、剧痒5年余,夏重冬轻反复加重.曾在外院按大疱性痒疹、结节性痒疹等治疗均无效,于2008年8月16日来本科门诊求治.曾于2岁时右膝部摔伤后缝合2针,伤口一直不愈合,用多种抗炎药物治疗无效,直到7岁时才愈合,留有色素沉着斑.10岁时右足背烫伤起疱、糜烂,经多种治疗至3个月后才愈合.家族中无同病患者,追询3代人中无近亲结婚史。

我们于2008年曾报告过“播散性阿萨希毛孢子菌病1例”[1],该例被十一家医院误诊2a多.近年来临床上仍可见类似的误诊.为了提高对深部真菌病疑难复杂病例的诊断水平,有必要对该例长期多次被误诊的原因进行认真地分析如下.

Objective To analyze fungal isolates from patients with superficial fungal infections during 1960-2006.Methods Fungal strains isolated from patients with superficial (mucocutaneous and cutaneous)fungal infections and identified in the Medical Mycology Clinical Laboratory,Department of Dermatology and Venereology,Union Hospital,from 1960 to 2006 (data from September 1991 to July 1992 were unavailable),were subjected to a classification and statistical analysis.Clinical samples for mycological examination were taken from outpatients or inpatients of different departments in hospitals of Hubei province and surrounding areas.Morphological,physiological and biochemical methods were applied for species identification.Results A total of 11 989 Candida strains were isolated,which belonged to 23 species and 16 genera.They fell into 3 groups,i.e.,dermatophytes,Candida and yeasts (including Malassezia),and non-dermatophyte moulds.Since 287 strains of moulds were suspected to be contaminating fungi,11 702 residual isolates were analyzed.Of the analyzed isolates,Candida species (5642/11 702,48.2％ )and dermatophytes (5279/11 702,45.1％ )predominated,followed by yeasts (449/11 702,3.8％) and Malassezia species (332/11 702,2.8％).The most frequently isolated species was Trichophyton rubrum (3865/11 702,33.0％),Candida albicans (3110/11 702,26.6％ ) and non-albicans Candida species (2532/11 702,21.6％ ).Dermatophyte strains were mostly isolated from lesions of smooth skin with an exception of palmoplantar and interdigit regions (1787/5279,37.7％).The most common dermatophyte species was Trichophyton rubrum,followed by Trichophyton violanceum.Candida was mainly isolated from mucous membrane lesions (4099/5642,72.7％),with Candida albicans being the predominant species.Conclusions Candida species and dermatophytes predominate in patients with superficial fungal infections during 1960-2006,with Trichophyton rubrum being the most common species.

Genitourinary candidiasis, which is most frequently caused by Candida albicans, is a common problem worldwide. The pathogenesis of the infection, especially recurrence of the infection, remains to be elucidated. This study analyzed 199 independent Chinese C albicans isolates using multilocus sequence typing (MIST) and microsatellite typing, with the focus on the isolates associated with vulvovaginal candidiasis (VVC) of Chinese women. MIST data of 221 vaginal isolates from other countries available from the consensus MLST database of C. albicans were retrieved for comparison. A total of 124 diploid sequence types (DSTs) were recognized from the Chinese C albicans isolates, among which, 98 (79.0%) have not been reported in the MIST database of the species. The majority of the VVC (71.6%) and balanitis (92.3%) isolates from China were located in clade 1 of C. albicans; while only 40.6% of the vaginal isolates and 7.8% of the oral isolates from healthy volunteers were found in the same clade. Furthermore, 69.1% of the VVC and 84.5% of the balanitis isolates concentrated in a cluster of clade 1 with DST 79 as the primary founder. The isolates in this cluster possessed microsatellite genotypes CAI 30-45, CAI 32-46 and their close derivatives. Interestingly, a remarkable difference in genotype distribution patterns between Chinese and non-Chinese vaginal isolates of C albicans was observed. Only 11.3% of the non-Chinese vaginal isolates compared were located in the cluster concentrated with Chinese WC isolates. The results suggest significant association of specific and genetically similar genotypes with genital infections in China. (C) 2011 Elsevier Inc. All rights reserved.

The essential oil produced from the seed of Anethum graveolens L. (Umbelliferae) was tested in vitro and in vivo anti-Candida activity. The microbroth dilution method was used in the minimal inhibitory concentration (MIC), according to M27-A3 of the guidelines of the Clinical and Laboratory Standard Institute (CLSI). And then, efficacy evaluation of essential oil in the prophylaxis and treatment of experimental vaginal candidiasis was performed in immunosuppressed mice. The anti-Candida activity was analyzed by microbiological and histological techniques and was compared with that of fluconazole (FCZ). The results showed essential oil was active in vitro against all tested strains, with MICs ranging from 0.312 μL/mL (for C. tropicalis, C. parapsilosis, and C. krusei) to 0.625 μL/mL (for 6 isolated C. albicans strains). Essential oil (2% v/v) was highly efficacious in accelerating C. albicans 09-1555 clearance from experimentally infected mice vagina by prophylaxis and therapeutic treatments. In both therapeutic efficacy and prophylaxis studies, the histological findings confirmed the microbiological results. The experimental results revealed that the tested essential oil is effective against vulvovaginal candidiasis in immunosuppressed mice.

皮肤病是一类可严重影响人们生活质量的常见病、多发病。大多数人都认为,此类疾病是由细菌、真菌和病毒感染引起的外在性疾病。其实,很多存在于人体内部的疾病都会在人体的表面以皮肤病的形式表现出来。也就是说,皮肤病往往是内在疾病在人体外部的表现。下面,笔者就根据一些典型的临床病案,介绍5种可由内科疾病引起的皮肤病:

A case of mutilating palmoplantar keratoderma of vohwinkel was reported.A 16-year-old female suffered from progressive palmoplantar hyperkeratosis for 16 years and annular constriction of bilateral 5th fingers and toes for 2 years.The X-ray showed that some substantia ossea have been destroied.Mutilanting palmoplantar keratoderma of vohwinkel was diagnosed.Ichthyosis was not associated with her.The patient's hearing was normal.Her father shared similar skin lesions with her.

A 67-year-old female farmer presented with a painless dark-erythematous, green bean-sized nodule on the left side of her head for 5 years.The nodule gradually grew and extended to the left temple.Three months prior to the presentation, the lesion began to enlarge rapidly and ulcerate.Histopathology of the lesion revealed a diagnosis of basal cell carcinoma.Brown hypha, spores, and blastospores were observed between cancer cell nests and in necrotic tissues.Culture of biopsy materials grew moist, glistening, olivaceous-black or dark yeast-like colonies, with gray fluffy hyphae at the margin.Slide culture showed brown branched and septate hypha, with spinate conidiophores arising terminally or laterally at right angles.There were rhino-protuberances at the tip of conidiophores together with clumps of smooth, oval microconidia at the top of or around the conidiophores, and many clear annellations were observed at the distant end of conidiophores.The strain was identified as Exophiala spinifera and confirmed genetically.The patient was diagnosed as phaeohyphomycosis caused by Exophiala spinifera superimposed on basal cell carcinoma based on the clinical manifestations,histopathological and mycological examinations, as well as DNA sequencing results.Clinical cure was achieved after management with oral itraconazole and 10-session photodynamic therapy.No recurrence was noted during 1-year follow-up.

Objective: To survey the dynamic epidemiologic change of pathogenic fungi in 8 regions of China during 1986, 1996 and 2006. Methods: The pathogenic fungi were collected from inpatients or outpatients from 8 geographical regions of China, i. e., East China, Central China, South China, Southwest China, North China, Northeast China, Northwest China and Taiwan of China, including more than 34 institutions. All cultures were identified by the unified criteria. Results: The number of pathogenic fungi isolated during 1986, 1996 and 2006 were 9 096, 19 009 and 33 022 strains, respectively. The 3 surveys found that the top fungal pathogen during 2006 was Candida albicans. Overall, the Candida and the molds gradually increased in these 3 surveys. During 1986, a total of 27 genera and species were isolated. During 1996, there were 108 genera and species. While during 2006, a total of 117 genera and species were isolated. Most of these isolates were Candida and Aspergillus. Conclusions: The 3 full-year surveys find that the pathogenic fungi in China vary with geographical regions and years. Overall, Candida species gradually increase from 6.3% in 1986 to 34.7% in 1996 and to 45.9% in 2006. It is of note that of all the Candida isolates, the ratio between Candida albicans and non-Candida albicans also gradually decreased.

A fourteen-month-old boy presented with a 9-month history of erythema,papules,nodules,abscesses and ulcers on left temple,neck and chest accompanied by fever and cough.He was hospimlized for suspected tuberculosis cutis,ecthyma and sporotrichosis.Hismpathology of nodules on the top of left chest showed a change characteristic of inflammatory granuloma with the presence of numerous fungal spores and hyphae.Under a microscope,a large number of hyphae were also observed in necrotic tissue specimen from the left neck with PAS staining.Fungal strains were isolated from both lesions and identified as Candida albicans.Laboratory examination revealed an increase in the serum leveI of hypersensitivity C reactive protein(14.4 mg/L)along with a decrease in total T cell proportion(40.21%)and the ratio of helper T cells to inducer T cells (26.4 1%).Anti-human immunodeficiency virus antibody was negative in this patient.Chest X-ray and computerized tomographic scanning(CT)showed an infection in bilateral lower lungs.After 3-month combined therapy with fluconazole,itraconazole,antibiotics,immunomodulators and supportive treatment,skin lesions were improved,and the lung infection was controlled after 8-month maintenance therapy with itraconazole.

>念珠菌致深部感染的发病率逐年升高,其临床表现多种多样,所致富尼埃坏疽发展迅速,若误诊漏治,预后严重。我们诊治念珠菌性阴茎富尼埃坏疽病1例,现报告如下。患者,17岁。阴茎疼痛、肿胀、溃疡伴发热2 d入院。静脉滴注头孢类抗生

报告周内首例解脂念珠菌(Candida lipdytica)肉芽肿.患者男,39岁.右颧外伤后结节进行性增多、扩大2年,经多次手术及多种抗生素、抗结核药物、泼尼松及环磷酰胺等治疗,均无效果.病情进行性加重,浸润性红褐色斑块和结节增多、扩大,累及双侧眼睑、面部、鼻及鼻窭,并有高热和剧痛.左下睑皮损组织病理检查为炎性肉芽肿,左面部溃疡组织及左上颌窦穿刺抽出物内含有大量较细的菌丝、关节孢子,结合核糖体DNA的转录间区(internal transcribed spacer,ITS)片段序列检测,鉴定为解脂念珠菌.