由申克孢子絲菌複合體引起的孢子絲菌病

A Case of Sporotrichosis Caused by Sporothrix Schenckii Complex

申克孢子絲菌複合體是一種雙型性黴菌，它偶而會引起皮膚的感染，通常生長在熱帶和溫帶地區，我們報告一位74男性，他的左上臂和左肩膀具有多發性慢性潰瘍的病灶已經有數年之久，經過清瘡手術後，病理切片檢查呈現肉芽腫性炎症，Hematoxylin and Eosin (H & E)染色發現有酵母菌；組織也做黴菌培養，在25℃溫箱下，Sabouraud葡萄糖瓊脂和ICG都有生長，以膠帶黏貼法並以苯酚藍染色後，再以光學顯微鏡觀察型態，對照圖譜是典型的申克孢子絲菌複合體，再把菌絲次培養在營養的培養基(例如：腦心浸液瓊脂)放於37℃溫箱培養後，菌絲轉成酵母菌是為確認試驗。

Sporothrix schenckii complex is a find of dimorphic fungi. Sporothrix schenckii complex occasional cause subcutaneous mycosis infection in human beings and occurs more common in tropic and temperate regions. Here we report a 74-year-old male with multiple chronic ulcers on left upper arm and left shoulder for several years. After wounds debridement, pathological examination reveals granulomatous inflammation. Fungal spores were found in the tissue sections with Hematoxylin and Eosin (H & E) stain. The tissue specimen was also performing mycology culture. Cottony colonies were observed on both Sabouraud dextrose agar plate and ICG agar plate (IMA plate with chloramphenicol and gentamicin) at 25℃. Further identification of S. schenckii complex was made by direct observation of typical mold morphology upon staining under the adhesive tape with lactophenol cotton blue. Colonies also transit to the yeast-like form after plating mycelia on brain heart infusion agar at 37 °C. In conclusion, histopathological examination and tissue fungus culture are both necessary for diagnosis sporotrichosis.