Hashemzadeh S, Tubbs R S, Fakhree M B A, Shoja M M
Mycoses. 2008 Jul;51(4):347-51. doi: 10.1111/j.1439-0507.2007.01487.x.
Mucormycosis is an emerging and fatal fungal infection. A high index of suspicion and the knowledge of its potential manifestations are essential for early diagnosis. We describe a patient with acute lymphoblastic leukaemia (L2 subtype) who developed a neck mass following a course of induction chemotherapy. Doppler ultrasonography and angiography of the neck revealed a pseudoaneurysm of the right common carotid artery. The patient then developed haemoptysis. Surgical exploration revealed a necrotic right common carotid artery with anteromedial pseudoaneurysm and adjacent tracheal wall perforation. Local debridement and tracheal repair were performed. Nonseptate hypheal invasion (mucormycosis) was found on the microscopic examination of the excised arterial wall. A subsequent recurrence of pseudoaneurysm was treated with local surgical debridement and intravenous amphotericin B (Fungizone) administration. Although rare, clinicians should be aware of these possible presenting features of mucormycosis as early diagnosis and treatment may potentially improve the survival.
毛霉菌病是一种新出现的致命真菌感染。高度的怀疑指数及其潜在表现的知识对于早期诊断至关重要。我们描述了一名急性淋巴细胞白血病（L2亚型）患者，在诱导化疗过程中出现颈部肿块。颈部多普勒超声和血管造影显示右颈总动脉假性动脉瘤。随后患者出现咯血。手术探查发现右颈总动脉坏死，伴有前内侧假性动脉瘤和相邻气管壁穿孔。进行了局部清创和气管修复。在切除的动脉壁显微镜检查中发现无隔菌丝浸润（毛霉菌病）。随后假性动脉瘤复发，采用局部手术清创和静脉注射两性霉素B（两性霉素B脂质体）治疗。尽管罕见，但临床医生应了解毛霉菌病这些可能的表现特征，因为早期诊断和治疗可能会提高生存率。
