Alfano Carmine, Chiummariello Stefano, Dessy Luca A, Bistoni Giovanni, Scuderi Nicolò
Department of Plastic and Reconstructive Surgery, University La Sapienza, Rome, Italy.
In Vivo. 2006 Mar-Apr;20(2):311-5.
Opportunistic fungal infections are rare, life-threatening conditions and are a major cause of morbidity and mortality in immunocompromised hosts. Our experience in the management of a case of combined mucormycosis and aspergillosis of the rhinocerebral region is presented.
The infection developed a few weeks after tooth extraction, massively involving facial structures. After diagnosis, the patient underwent prolonged combined systemic antifungal treatment. Once the local and general conditions had stabilized, an extensive surgical debridement was performed, followed by reconstruction with a pedicled myocutaneous flap.
This approach was curative with patient survival after 16 months.
Early diagnosis, early anti-fungal treatment and early stabilization of the patients' general condition are fundamental for patient survival. Surgery is necessary for fungal eradication, but must be performed according to the above conditions. Pedicled muscle flaps are considered the first reconstruction choice because of their excellent blood perfusion and resistance to fungal invasion.
机会性真菌感染是罕见的、危及生命的疾病，是免疫功能低下宿主发病和死亡的主要原因。本文介绍了我们对一例鼻脑区域合并毛霉菌病和曲霉菌病病例的治疗经验。
感染在拔牙后几周出现，广泛累及面部结构。诊断后，患者接受了长时间的联合全身抗真菌治疗。一旦局部和全身状况稳定，即进行广泛的手术清创，随后采用带蒂肌皮瓣进行重建。
该方法治愈了患者，患者在16个月后存活。
早期诊断、早期抗真菌治疗以及患者全身状况的早期稳定是患者存活的基础。手术对于根除真菌是必要的，但必须根据上述条件进行。带蒂肌瓣因其良好的血液灌注和抗真菌侵袭能力而被认为是首选的重建方式。
