A case of cutaneous Busse-Buschke granuloma with lung infection caused by Candida albicans

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Author:
ZHENG Yue-chen(Department of Dermatology and Venereology,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,Chian)
LIU Zhi-xiang(Department of Dermatology and Venereology,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,Chian)
FENG Ai-ping(Department of Dermatology and Venereology,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,Chian)
TU Ya-ting(Department of Dermatology and Venereology,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,Chian)
LIU Hou-jun(Department of Dermatology and Venereology,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,Chian)
HUANG Chang-zheng(Department of Dermatology and Venereology,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,Chian)
MAO Ye-hong(Department of Dermatology and Venereology,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,Chian)
Journal Title:
INTERNATIONAL JOURNAL OF DERMATOLOGY AND VENEREOLOGY
Issue:
Volume 35, Issue 03, 2009
DOI:
10.3760/cma.j.issn.1673-4173.2009.03.003
Key Word:
Candidiasis;Granuloma;Pneumonia

Abstract: A fourteen-month-old boy presented with a 9-month history of erythema,papules,nodules,abscesses and ulcers on left temple,neck and chest accompanied by fever and cough.He was hospimlized for suspected tuberculosis cutis,ecthyma and sporotrichosis.Hismpathology of nodules on the top of left chest showed a change characteristic of inflammatory granuloma with the presence of numerous fungal spores and hyphae.Under a microscope,a large number of hyphae were also observed in necrotic tissue specimen from the left neck with PAS staining.Fungal strains were isolated from both lesions and identified as Candida albicans.Laboratory examination revealed an increase in the serum leveI of hypersensitivity C reactive protein(14.4 mg/L)along with a decrease in total T cell proportion(40.21%)and the ratio of helper T cells to inducer T cells (26.4 1%).Anti-human immunodeficiency virus antibody was negative in this patient.Chest X-ray and computerized tomographic scanning(CT)showed an infection in bilateral lower lungs.After 3-month combined therapy with fluconazole,itraconazole,antibiotics,immunomodulators and supportive treatment,skin lesions were improved,and the lung infection was controlled after 8-month maintenance therapy with itraconazole.

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