[Cutaneous protothecosis: first case in Taiwan].

Y Z Kuan, Y C Lee
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Abstract

In November 1985, a 5-year-old Chinese girl presented to the Dermatological Department of Chang Gung Memorial Hospital, Taipei, having scaly erythematous plaque with mild itching on her right upper eyelid. Skin biopsy and fungal cultures were performed after failure of initial topical steroid therapy. The histopathology revealed many acute and chronic inflammatory cells infiltrating the dermis and H & E stain revealed some foamy vacuolated spores; P.A.S. and Gomori's methenamine stain also showed many spores and sporangia containing endospores. Lactophenol cotton blue and methylene blue wet mount preparations were made from the colony growing on Sabouraud's agar. Microscopically, these showed many round or oval spores and endospore-containing sporangia, corresponding with the histopathology. This microorganism grew as a milky white yeast-like colony on Sabouraud's dextrose agar, blood agar, EMB, Tween 80 cornmeal agar, chocolate agar, MacConkey agar and brain heart infusion with sheep RBC agar. On Pagano-Levin medium, the colony became deep red in color and in the thioglycollate broth tube culture, it was suspended on the upper layer as a whitish ring-form of granules. The microorganism showed no urease activity. In the assimilation tests, there were positive reactions to glucose, galactose, trehalose, fructose, mannose and glycerol, and negative reactions to maltose, xylose, raffinose, sucrose, lactose, cellabiose, n-propanol, etc. The electronmicroscopic examination of the colony revealed sporangium containing spores and characteristic dense body and plastids in the spores.(ABSTRACT TRUNCATED AT 250 WORDS)

皮肤原鞘病:台湾首例。
1985年11月,一名5岁的中国女孩因右上眼睑有鳞状红斑斑块并轻度瘙痒而来到台北长庚纪念医院皮肤科就诊。最初局部类固醇治疗失败后进行皮肤活检和真菌培养。组织病理学检查发现真皮有大量急、慢性炎性细胞浸润,h&e染色见泡沫状空泡孢子;P.A.S.和Gomori的甲基苯丙胺染色也显示许多孢子和孢子囊含有内生孢子。以Sabouraud’s琼脂上生长的菌落为原料,制备了乳酚棉蓝和亚甲基蓝湿载制剂。镜下可见许多圆形或卵圆形的孢子和含孢子的孢子囊,与组织病理学一致。这种微生物在Sabouraud’s葡萄糖琼脂、血琼脂、EMB、Tween 80玉米粉琼脂、巧克力琼脂、MacConkey琼脂和羊红细胞琼脂脑心输注上生长为乳白色酵母样菌落。在Pagano-Levin培养基上,菌落呈深红色,在巯基乙酸盐肉汤管培养中,菌落以白色环状颗粒悬浮在上层。该微生物无脲酶活性。在同化试验中,对葡萄糖、半乳糖、海藻糖、果糖、甘露糖和甘油有正反应,对麦芽糖、木糖、棉子糖、蔗糖、乳糖、纤维素糖、正丙醇等有负反应。菌落的电镜检查显示含有孢子的孢子囊,孢子中有典型的致密体和质体。(摘要删节250字)
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