ringworm_jrt_Mar94

1、Facial alopecia, 面部禿頭scaling and erosions 結(jié)痂與侵蝕in a Jack Russell terrier 杰克羅素梗Author: Ross BondEditor: 蒿子楓 European Society of Veterinary Dermatology T. mentagrophytesHistory | Signs | Differentials | Tests | Therapy | NotesClick to reveal the text on this screenClick the forward arrow to jump to th

2、e next screenHistory 病史- 1History10 year-old entire male Jack Russell terrier 10歲未節(jié)育公犬Good general health 健康Progressive facial skin disease of 4 months duration持續(xù)4個月的進行性面部皮膚病No response to ampicillin and prednisolone對氨芐西林與潑尼松龍無效History | Signs | Differentials | Tests | Therapy | NotesHistory - 2Hist

3、oryDog lives in rural environment 住在鄉(xiāng)下Lesion began as focal area of erythema and scaling caudal to nasal planum損傷自局部紅疹,從后面向鼻結(jié)痂Progressed caudally over face despite therapy 盡管治療,還是從尾向前面部發(fā)展History | Signs | Differentials | Tests | Therapy | NotesClinical signs - 1Signs Severe skin disease;嚴重皮膚病 lesion

4、 well-demarcated損傷邊界清析 Smooth-silvery skin at healing areas rostrally嘴部痊愈的皮膚呈銀白色平滑 Alopecia, scaling, erosions禿頭癥,結(jié)痂,侵蝕 Nasal planum unaffected鼻頭未被感染History | Signs | Differentials | Tests | Therapy | NotesHow would youapproach this case?SignsWhat are the next steps you would take? 下一步?Make a list o

5、f your principle differential diagnoses DDX?List any samples you would collect采什么樣?List any tests you would perform to assist in making a definitive diagnosis要做哪些測試History | Signs | Differentials | Tests | Therapy | NotesTests - 1DifferentialsPrinciple differential diagnoses 主要鑒別診斷Dermatophytosis皮真菌

6、病Demodecosis蠕形螨Deep pyoderma深部膿皮病Pemphigus foliaceus落葉天皰瘡History | Signs | Differentials | Tests | Therapy | NotesTests - 2TestsDiagnostic tests診斷測試Skin scrapings刮片Woods light examination伍德燈Fungal and bacterial cultures真菌與細菌培養(yǎng)(Skin biopsy)活檢History | Signs | Differentials | Tests | Therapy | NotesRe

7、sults - 1TestsNo evidence of parasites & fungal elements on microscopy鏡下未見寄生蟲與真菌No fluorescence on Woods light examination伍德燈未見熒光Fungal growth evident on mycobiotic agar within 7 days of incubation真菌培養(yǎng)需要7天孵化History | Signs | Differentials | Tests | Therapy | NotesResults - 2Tests White colonies

8、with granular texture顆料狀的白色菌落 Dark tan / brown reverse pigment 深咖啡/棕色 背景色 On microscopy, numerous microconidia and thin-walled cigar-shaped macroconidia很多小孢子與薄壁雪茄狀大分生孢子 Trichophyton mentagrophytes (granular form)須毛癬菌(顆粒狀)Fungal culture: Sabourauds dextrose agar 5 days 沙氏沙氏葡萄糖瓊脂葡萄糖瓊脂 五天五天History | Si

9、gns | Differentials | Tests | Therapy | NotesWhat is yourdiagnosis?TestsDo the investigations permit a definitive diagnosis? 這可以是最終的診斷嗎?Are there any additional investigations which you think may need to be done? 還需要做其它調(diào)查嗎?History | Signs | Differentials | Tests | Therapy | NotesDiagnosisTestsDermat

10、ophytosis caused by T. mentagrophytes須毛癬菌引起皮膚真菌病Historical and clinical features strongly suggestive, supported by culture results培養(yǎng)結(jié)果驗證了病史與臨床特征Skin biopsies confirmed hair shaft and follicle invasion by fungal elements皮膚活檢證實毛干與毛囊被真菌菌絲入侵History | Signs | Differentials | Tests | Therapy | NotesHow wo

11、uld you deal with this case?What is your prognosis?你的診斷是?How will you advise the owner?你給主人的建議是?What treatment would you consider?你的治療方案是?TestsHistory | Signs | Differentials | Tests | Therapy | NotesPrognosisTestsPrognosis is good診斷很好However, lengthy antifungal therapy is often needed with Trichoph

12、yton infections in dogs然而須毛癬菌需要漫長的抗真菌藥治療History | Signs | Differentials | Tests | Therapy | NotesTherapyTherapyGriseofulvin orally at 50 mg/kg (divided twice daily)灰黃霉素 口服,50mg/kg每天分兩次Enilconazole (Imaverol) emulsion applied every 4th day 恩康唑乳劑Good clinical response after 8 weeks of therapy, but rep

13、eat cultures still positive8周后有好轉(zhuǎn)但培養(yǎng)陽性Cultures negative and complete clinical response after 12 weeks of treatment, which was withdrawn at this time12周后培養(yǎng)陰性并徹底好轉(zhuǎn),停止治療No relapse over a 6 month follow-up period6月后回訪未復(fù)發(fā)History | Signs | Differentials | Tests | Therapy | NotesComment -1NotesOwners lesio

14、ns were present in this case, illustrating the zoonotic potential of canine dermatophytosis這個病中主人也有相似損傷,說明犬皮膚真菌病是動物傳染病Jack Russell terriers are predisposed to sylvatic dermatophytosis in the U.K.在英國這種犬易患真菌The peripherally expanding, well-demarcated lesions on the face were suggestive of dermatophyto

15、sis向周圍擴散,界限清楚,暗示真菌病History | Signs | Differentials | Tests | Therapy | NotesComment -2NotesLesions of dermatophytosis vary in appearance and severity皮膚真菌病損傷在外表與嚴重性有不同Severely inflamed Trichophyton lesions on the face are misdiagnosed as pemphigus foliaceus嚴重發(fā)炎的面部須毛癬菌病會被誤診為落葉天皰瘡Absence of focal crusted lesions (“footprints” of vesicopustules