ABSTRACT
The patient,a 51-year-old veterinarian,was hospitalized for a two-month history of painful oral ulcers without fever.Physical examination revealed two superficial ulcers in the palate.Laboratory examination showed a decrease in peripheral blood leucocytes as well as a hyperplasia of bone marrow.No abnormality was found by X-ray radiography or B-mode ultrasonography.The paileat tested negative for anti-HIV antibody.Classification Of CD+ cells showed that CD3+ cells amounted to 0.559,CD4+ cells 0.289,CD8+ cells 0.207,CD4:CD8 ratio 1.4,and all the parameters were in a normal range.Histopathological analysis of the ulcer tissue revealed a chronic inflammatory granuloma with clustered yeast-like cells.Fungal culture of the sample from ulcer tissue at 25℃on the slant of PDA yielded white filamentous colony;typical rudder-like macroconidias were observed with electronic microscopy following microculture;and the isolate showed a biphasic growth pattern.PCR was performed to amplify the internal transcribed spacer 1 (ITS1)and D1/D2 region of the isolated fungus followed by sequence analysis,and a homology of 97%and 99%was observed in the sequence of ITS1 and D1/D2 region,respectively,between the isolate and standard strain of Histoplasma capsulatum.A diagnosis of primary oral histoplasmosis Was made.The lesions subsided after 2-month treatment with oral itraconazole 400 mg per day.
ABSTRACT
OBJECTIVE To supervise the environmental fungal load and species distribution in transplantation department and intensive care unit of the Southwest Hospital,and to analyze the relationship with season,temperature,humidity,ventilation and personnel activities.METHODS Data from Dec 2005 to Jan 2006 were collected from liver transplantation department(LTD),cerebral surgery intensive care unit(CSICU) and central intensive care unit(CICU).Air,surfaces and tap water were sampled twice a month at each department.RESULTS The air fungal load was 123.63 CFU/m3,139.90 CFU/m3,7 CFU/m3 and 217.71 CFU/m3 at LTD,CSICU,CICU and outdoor,respectively.The five most prevalent fungi collected from air and surface were Penicillium spp,Cladosporium spp,Alternaria spp,Aspergillus spp and Saccharomyces spp in turn.The five most prevalent fungi collected from water were Saccharomyces spp,Candida spp,Aspergillus spp,Penicillium spp and Rhodotorula spp in turn.The fungal load in LTD was positively correlated with the average temperature and the average humidity;the fungal load in CSICU was correlated with the average temperature and the average humidity,but the correlation between air fungal load and personnel activities wasn′t observed.CONCLUSIONS It demonstrated the fungi are found in the environment of the hospital including air,surface and water.The air fungal load varies throughout the year.The crest-time is May to June and September to October.Air fungal load is lower in winter and higher in summer and autumn.The correlation between air fungal load and temperature and humidity is observed.