口腔咽頭病変を来した南アメリカ分芽菌症

Abstract

South American Blastomycosis with oral and pharyngeal mucosal disease and lymphnode swelling was diagnosed in a 47-year old male, who had lived in Brazil from 1962 to 1967. He complained of abnormal sensation of the oral cavity in February 1989 and more recently noticed a tumor of the oral mucosa. He visited our clinic on July 31. On admission, a granulomatous tumor with ulceration was seen at the retromolar lesion. Mucosa erosions were found in the soft and hard palates. Lymphnode swellings were observed bilaterally after admission. Histological examination revealed granulomatous infiltration with epithelioid and giant cells. Fungus spores were seen within giant cells and free in the infiltrate. Cultures revealed yeast cells in cross sections with the shape of a marine pilot's wheel. Histological examination and culture studies led to a diagnosis of South American Blastomycosis. Fluconazole treatment was very effective.Imported infections are no longer rare. South American Blastomycosis should be considered in the differential diagnosis of oral and pharyngeal mucosal disease with lymphnode swelling.