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Symptoms of Du Bo's histoplasmosis
Early symptoms:. localized type may be single skin lesion, subcutaneous granuloma or single bone lesion, without systemic symptoms such as fever, anemia or weight loss
Late symptoms: emaciation, fatigue, anemia and fever
Related symptoms: lymph node enlargement and slow growth of granuloma
1. Localized type can be single skin lesion, subcutaneous granuloma or single bone damage, without systemic symptoms such as fever, anemia or weight loss, chronic course, asymptomatic or recurrent, and self-healing.
2. Disseminated type is spread in skin, lymph nodes, bone, intestine and abdominal organs. This type can be acute progression to death, affecting liver, spleen and even the whole body, especially bone and skull lesions can be similar to multiple myeloma, metacarpal and phalangeal lesions can be like sarcoidosis, groin or systemic lymph node enlargement can be very serious, like paracoccidiosis. Patients may have fever, emaciation, fatigue and severe anemia, etc. This bacterium can be found in skin and blood, and the number of white blood cells often remains unchanged.
Mainly based on mycological examination.
1. When taking skin lesions, pus, bone lesions, sinuses or biopsy materials directly under microscope, many bacteria can often be found. Saccharomyces cerevisiae cells with a diameter of 12 ~ 15 μ m can be seen on KOH smear, and fat droplets can be seen in the cells. In a few cases, buds with wide bottom can also be seen, just like dermatitis blasts, so they should be cultured and identified.
2. Fungi were cultured on sandcastle agar containing antibiotics at 25 ℃, and grew slowly, sometimes it took 4 ~ 6 weeks to start growing, and gradually formed white to brown villous colonies, like Histoplasma capsulatum. Microscopic examination can also see small conidia and large conidia with spines. When the seeds were transferred to blood agar at 37 ℃, they were quickly transformed into yeast phase, often small yeast type, and sometimes thick-walled cells with a diameter of 12 ~ 15 μ m were seen. When transformed into this large Du Bo yeast cell, the small capsular cells can no longer be found.
3. Biochemical reaction: This bacterium was negative in urea test, and it could liquefy gelatin within 24 ~ 96 hours, while capsular serothelial bacteria were not.
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