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Aspergillus属は,元来土壌,植物,穀物などへの腐生菌であり,時として動物への感染もある。特に鳥類の気嚢や肺を侵し,鶏や七面鳥の育成中の雛に多発して育雛肺炎と呼ばれる。これが,時に人体に対して病原性を示して種々の臓器を侵す。1856年,Virchow1)の4例の剖検例の報告を最初として内科,耳鼻咽喉科領域での報告があいつぎ,わが国でも緒方2)(1908年)が肺アスペルギルス症を報告したのを始めとして多数の報告がある。特に最近では,抗生物質,副腎皮質ホルモン剤などの使用によつて真菌症が増加の傾向にあり,本症が重要視されるに至つた。しかし,皮膚科領域では,1925年,Hodara und Behdjet3)の報告以後10余例を算するにすぎず,まれな疾患とされている。筆者らはこのたび僧帽弁狭窄兼閉鎖不全症の患者の人工弁置換術後に発生した座瘡様皮疹を経験し,その膿疱内にAspergillus fla-vusを証したので,これにAspergillosis cutisacneiformisと命名し,これを下記する。
A 41-year-old man showed the acneiform eruption in the indurated skin on the right scapular region after the operation of changing the mitral valve to a metalic one for the stenosis and incomplete closure of the mitral valve, It started after the postoperative administration of anti-biotics and adrenocortical hormone, and showed a remarkable improvement by a topical applica-tion of nystatin.
Histologic specimen showed folliculitis, with destruction of hair follicle and infiltration of his-tiocytes, plasma cells and lymphocytes around the polynuclear Leucocytes accumulation. Few foreign-body giant cells were observed. Keratotic cysts could be found, in which fungus elements were proved by PAS staining.
Aspergillus flavus was cultivated on Sabouraud's Glucose Agar from the pus and tissue.Intraperitoneal inoculation of this strain of the fungus introduced white nodules in the liver, kidney, and bladder with the histologic finding of which was an exudative inflammatory reaction containing the spore.
Sensitivities of this fungus to Amphotcricin B and Nystatin were 250 r/ml and 80 u/ml respec-tively.
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