Lobomycosis in a Post-Covid 19 Patient: A Case Report and Review of Literature.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-01-01 DOI:10.5146/tjpath.2023.01604

Sateesh S Chavan, Thotadamane Nagaraja Chandrashekhar

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Abstract

Aim: To document a case of lobomycosis and to discuss its epidemiology & diagnosis.

Case report: A 53-year-old male presented with a history of nasal congestion, nasal discharge, and epistaxis following Covid 19 infection. On physical examination, there was necrotic slough in the nasal vestibule near the inferior turbinate. Scrapings and punch biopsy were taken from the lesion. Hematoxylin-eosin-stained sections showed necrotic and mucoid areas with mixed inflammatory cell infiltration and numerous budding yeasts 3- 7μm diameter in singles, and small clusters with single narrow based budding as well as multiple budding including sequential budding forming "chains of yeasts". A diagnosis of Lobomycosis was made. Yeasts of lobomycosis are often confused with other yeasts such as P. brasiliensis, Candida spp., B. dermatitidis, and Cryptococci, but characteristic 'sequential budding' with a 'chain of yeasts" aid in the final diagnosis. Demonstration of yeasts with characteristic chains either in tissue sections or in potassium hydroxide (KOH) preparation of scraped material, exudate, or exfoliative cytology is the mainstay in the diagnosis as the organisms are uncultivable in vitro in culture medium.

Abstract Image

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一例19岁后患者的脑脊髓炎：病例报告和文献回顾。

目的：记录一例脑脊髓炎，并讨论其流行病学和诊断。病例报告：一名53岁男性，新冠肺炎19感染后有鼻塞、鼻腔分泌物和鼻出血史。体检发现，下鼻甲附近的鼻前庭有坏死的泥沼。对病变进行刮片和穿刺活检。苏木精-伊红染色切片显示坏死和粘液样区域，有混合炎症细胞浸润，单个直径为3-7μm的大量出芽酵母，小簇有单个窄基出芽和多个出芽，包括连续出芽形成“酵母链”。诊断为脊髓炎。脑脊髓炎的酵母通常与其他酵母混淆，如巴西假单胞菌、念珠菌属、皮霉菌和隐球菌，但具有“酵母链”的特征性“连续出芽”有助于最终诊断。在组织切片或氢氧化钾（KOH）制备刮除材料、渗出物或脱落细胞学中证明具有特征链的酵母是诊断的主要内容，因为这些生物体在培养基中无法在体外培养。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.