论文部分内容阅读
目的:了解上海地区儿童甲真菌病的主要临床特征和病原菌种类。方法:分析该院门诊2011年10月一2012年10月确诊的33例儿童(≤14岁)甲真菌病病例,男21例,女12例。病程2周~2个月,均未使用过抗真菌药物。结果:单纯甲部感染者31例,2例患儿并发足癣。临床分型:远端侧缘甲下型(DLSO)15例、浅表白甲型(SWO)10例、近端甲下型6例、全甲毁损型1例、甲板内型1例。实验室检查:直接镜检阳性33例,培养鉴定分离皮肤癣菌21株,包括红色毛癣菌18株(54.5%)、趾间毛癣菌2株(6.0%)、絮状表皮癣菌1株(3.0%);分离念珠菌属10株,包括白念珠菌5株(15.2%)、近平滑念珠菌5株(15.2%);分离曲霉菌1株(3.0%);未发现混合感染的病例。7例累及指甲的病原菌均为念珠菌,包括4株白念珠菌和3株近平滑念珠菌。所有患儿经外用药或口服药联合治疗后临床和真菌学均痊愈。结论:儿童甲真菌病的特点是病程较短,并发其他浅部真菌病者较少,传染自密切接触的成年人可能性较大。儿童甲真菌病以DLSO型和SWO型较多。实验室检查必须保证取材的质量,提高真菌学检查阳性率。经规范治疗一般可以痊愈。
Objective: To understand the main clinical features and pathogens of onychomycosis in children in Shanghai. Methods: A total of 33 cases of onychomycosis (≤14 years old) diagnosed in our hospital from October 2011 to October 2012 were analyzed, including 21 males and 12 females. Duration of 2 weeks to 2 months, have not been used antifungal drugs. Results: A simple infection in 31 cases, 2 cases of children with tinea pedis. There were 15 cases of DLSO, 10 cases of superficial white matter (SWO), 6 cases of proximal hypothyroidism, 1 case of total nail destruction and 1 case of internal deformity. Laboratory tests: Direct microscopy positive 33 cases, 21 strains of dermatophytes were isolated and identified, including 18 Trichophyton rubrum (54.5%), 2 Trichophyton mentagrophytes (6.0%), Epidermophyton floccosum 1 5 isolates of Candida albicans (15.2%), 5 strains of Candida parapsilosis (15.2%), 1 isolates of Aspergillus (3.0%), no mixed infection Case. The pathogenic bacteria of 7 cases involving nails were Candida albicans, including 4 Candida albicans and 3 Candida parapsilosis. All children were clinically and mycologically recovered after external or oral treatment. CONCLUSION: Children with onychomycosis are characterized by shorter duration of disease, fewer cases of other superficial fungal diseases, and greater likelihood of transmission of intimate contact with adults. Children with onychomycosis DLSO type and SWO type more. Laboratory tests must ensure that the quality of the material, improve mycology check positive rate. The standard treatment can generally be cured.