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一名看似正常宿主发生的致命性鼻眶脑毛霉菌病:病例报告及文献综述

Fatal rhino-orbito-cerebral mucormycosis in an apparently normal host: case report and literature review.

作者信息

Sharma R R, Pawar S J, Delmendo A, Lad S D, Athale S D

机构信息

The National Neurosurgical Centre & Department of Anaesthesiology, Khoula Hospital, PC-116, Mina-Al-Fahal, Muscat, Sultanate of Oman.

出版信息

J Clin Neurosci. 2001 Nov;8(6):583-6. doi: 10.1054/jocn.2000.0818.

Abstract

Fungal infections of the central nervous system (CNS) are fortunately rare but remain challenging problems occurring mostly in immunocompromised individuals, with protean manifestations, unpredictable course and unfavorable outcome in many cases despite aggressive neurosurgical intervention and recent antifungal drugs. Rhino-orbito-cerebral mucormycosis is a potentially lethal opportunistic fungal infection with rapid progression and high mortality. Its pathogenic nature becomes evident when the patient's general resistance is compromised. We present a case of an invasive rhino-orbito-cerebral mucormycosis in an apparently normal adult who initially developed mild paranasal sinusitis and later developed status epilepticus and despite an aggressive management died. Interesting clinical, neuroimaging and histological findings are described, and the possibility of fatal mucormycosis in an apparently normal host is highlighted.

摘要

中枢神经系统(CNS)真菌感染所幸罕见,但仍是具有挑战性的问题,主要发生在免疫功能低下的个体中,表现形式多样,病程难以预测,尽管采取了积极的神经外科干预措施并使用了最新的抗真菌药物,许多病例的预后仍不理想。鼻眶脑毛霉菌病是一种具有潜在致命性的机会性真菌感染,进展迅速,死亡率高。当患者的全身抵抗力受损时,其致病本质就会显现出来。我们报告一例侵袭性鼻眶脑毛霉菌病病例,患者为一名看似正常的成年人,最初患轻度鼻窦炎,后来发展为癫痫持续状态,尽管进行了积极治疗仍死亡。文中描述了有趣的临床、神经影像学和组织学发现,并强调了看似正常的宿主发生致命毛霉菌病的可能性。

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