紫斑を呈した続発性ムーコル症

・体幹・下肢に小水疱を伴う紫斑を散在性に認め，さまざまな鑑別疾患が考えられた．

・皮疹は，肺病変より血行性に播種したムーコル菌によって生じていた．

・免疫抑制状態の患者では，深在性真菌症による紫斑の可能性も念頭に置く必要がある．

（「症例のポイント」より）

　

A case of secondary disseminated cutaneous mucormycosis presenting as purpura

　

Take, Nobutoshi1）Tsuji, Gaku1）Takahara, Masakazu2）Matsuda, Tetsuo3）Furue, Masutaka1） 1）Department of Dermatology, Kyushu University School of Medicine 2）Takahara Dermatology Clinic 3）Matsuda Dermatology Clinic

　

A 65-year-old woman presented with multiple purpura on both legs. Histological examination of the purpura revealed embolus due to a clot in the dermat capillary. The vessels stained positive for fungal elements with PAS stain. Culture test revealed the isolated strain to be zygomycetes. A chest computed tomography scan demonstrated an infiltrative shadow in the left lung field, and Cunninghamella spp. was detected in expectoration culture. We diagnosed the case as secondary disseminated cutaneous mucormycosis from a pulmonary lesion. The patient was treated with amphotericin B liposome preparation (5 mg/kg/day)； however, she died in a few days.