摘要
目的:报告1例由万博节皮菌(趾间毛癣菌有性期)引起的脓癣。在患儿已口服抗真菌药培养生长缓慢的情况下从病发直接提取DNA鉴定菌种,以明确致病菌,指导治疗。方法:病发经KOH涂片真菌镜检阳性后,从病发直接提取DNA,以真菌通用引物ITS1和ITS4做PCR扩增后测序比对;同时做真菌培养,菌落长出后做钢圈小培养进行形态学鉴定。并提取菌落DNA做分子生物学鉴定。结果:病发直接提取的DNA与从培养菌落提取的DNA经PCR-序列分析均鉴定为万博节皮菌.与形态学鉴定相符。诊断万博节皮菌感染所致头癣。予口服伊曲康唑(100mg/d),2%酮康唑洗剂外洗后外擦1%萘替芬-0.25%酮康唑乳膏。治疗4个月后痊愈。结论:在已用抗真菌药培养生长不良的情况下直接提取DNA做PCR-序列分析的非培养法能尽早明确致病菌种,指导用药。待培养菌落长出后再做PCR-序列分析及形态学验证。
Objective： To report a girl with kerion due to Arthroderma vanbreuseghemii. The culture is slow after oral terbinafine. By extracting DNA from affected hairs, the pathogenic isolate is identified to direct treatment. Methods： With positive result of KOH examination, the hairs drawn from the affected area was divided into two parts： one for culture-inde- pendent PCR and another for culture. DNA extracted directly from the hair was amplified using the universal fungal primers ITS1 and ITS4, The sequences of amplification products were blasted in GenBank. Twenty-eight days after incubation, take the colony for slide culture for morphologic validation. DNA was extracted from the isolated colony for molecular biological validation. Results： The two sequences from hairs and from isolated colony were both identified as Arthroderma van- breuseghemii, the teleomorph of Trichophyton interdigitale. Kerion due to A.vanbreuseghemii was diagnosed. The patient was treated with oral itraconazole 100 mg per day and topical application of a cream containing 1% naftifine-0.25% ketoconazole when got the positive KOH examination. For 4 months treatment, the girl was cured. Conclusion： PCR-based molecular bio- logical validation of DNA from hair can rapidly identify the pathogenic fungus, especially after using antifungal drugs. The result which verified by the followed process from the isolate can indicate the correct choice of antifungal drug.
出处
《临床皮肤科杂志》
CAS
CSCD
北大核心
2013年第6期348-350,共3页
Journal of Clinical Dermatology
