Dubo histoplasmosis
Introduction
Introduction to Dubo's cytoplasmic disease Histoplasmosis duboisii is a granulomatous and suppurative lesion of the skin, subcutaneous tissue and bone tissue caused by the capsular histoplasma Dubo variant, rarely invading the lungs. basic knowledge Sickness ratio: 0.0001% Susceptible people: no special people Mode of infection: non-infectious Complications: anemia
Cause
Dubo tissue cytoplasmic disease
Localized infection (35%):
Can be a single skin lesion, subcutaneous granuloma or single bone damage, no fever, anemia or weight loss and other systemic symptoms, chronic course, can be asymptomatic or recurrent, can be self-healing.
Dispersion type (55%):
That is, the spread of skin, lymph nodes, bones, intestines and abdominal organs, this type can be acutely fatal, affecting the liver, spleen, and even the whole body, especially bones, skull lesions can be similar to multiple myeloma, palm and phalangeal lesions can be like Sarcoidosis, groin or generalized lymphadenopathy may be very similar, such as parasporosis, the bacteria can be found in the skin and blood, and the number of white blood cells is often unchanged.
Prevention
Dubo cytoplasmic disease prevention Temperance in life: pay attention to rest, work and rest, life in an orderly manner, and maintaining an optimistic, positive and upward attitude towards life can be of great help in preventing diseases.
Complication
Dubo cytoplasmic complication Complications anemia
Suffering from severe anemia.
Symptom
Dubo histoplasmosis symptoms common symptoms lymph node enlargement slow growth granuloma
1. Limited type: can be a single skin lesion, subcutaneous granuloma or single bone damage, no fever, anemia or weight loss and other systemic symptoms, chronic course, can be asymptomatic or recurrent, can be self-healing.
2. Dissemination type: It is spread in the skin, lymph nodes, bones, intestines and abdominal organs. This type can be acutely fatal, affecting the liver, spleen, and even the whole body, especially bones. Skull lesions can resemble multiple myeloma. Palm and phalangeal lesions may be like sarcoidosis, groin or generalized lymph node enlargement, such as parasporosis, patients may have fever, weight loss, fatigue and severe anemia, etc., bacteria can be found in skin and blood, white blood cells The number is often unchanged.
Examine
Dubo's examination of histoplasmosis
Direct microscopy: When taking skin lesions, pus, bone damage, sinus or biopsy materials, many cells can often be found. Fungal culture: cultured on sandcastle agar containing antibiotics, 25 ° C, slow growth, sometimes It began to grow in 4-6 weeks, and gradually formed white to brown villous colonies, like capsular histoplasma. Microscopic conidia and large conidia with spines were also observed by microscopy.
Biochemical reaction: The urea test of this bacteria is negative, and gelatin can be liquefied within 24 to 96 hours, while the capsular tissue histoplasma is not.
Histopathology: It is often seen that a large number of giant cells, up to 200 m or larger, contain many ovoid yeast cells, about 12-15 m in diameter, and sometimes 4-5 strands, such as yeast cells of dermatitis germination. However, there is no wide bud neck, and other inflammatory cells such as neutrophils can be seen. In the cheese-like zone, extracellular degeneration yeast can be seen, which is a small or large spherical vacuolar cell, which can be seen by HE staining, GMS, GF and PAS staining is clearer and there are fewer cells in healing fibrotic lesions.
Diagnosis
Diagnosis and identification of Dubo's histoplasmosis
Diagnostic criteria
Mainly based on mycological examination.
1. Direct microscopic examination: When taking skin lesions, pus, bone damage, sinus or biopsy materials, many cells can often be found. KOH smears can be seen in thick-walled yeast cells with a diameter of 12-15 m. In a few cases, wide-bottom buds can also be seen, such as dermatitis buds, so culture should be identified.
2. Fungal culture: cultured on sandcastle agar containing antibiotics, growing slowly at 25 ° C, sometimes it takes 4 to 6 weeks to start growing, gradually forming white to brown fluffy colonies, like capsular histoplasma, mirror Small conidia and large conidia with spines can also be seen. When they are transplanted to blood agar at 37 °C, they are quickly converted into yeast phase, often small yeast type, sometimes visible in the thickness of 12-15 m. When the parietal cells are transformed into such large Dubo yeast cells, small capsular cells can no longer be found.
3. Biochemical reaction: The urea test is negative, and gelatin can be liquefied within 24 to 96 hours, while the capsular group is not.
Differential diagnosis
The difference between this disease and capsular histoplasmosis.
