Takakura Shunji
Department of Infection Control and Prevention, Kyoto University Hospital.
Nihon Rinsho. 2008 Dec;66(12):2356-61.
Zygomycosis is an invasive fungal infection with extremely high mortality caused by filamentous fungi which belong to Class Zygomycetes (Rhizopus spp., Mucor spp., Cunninghamella spp., etc). Despite of the similarities of the ecological characteristics and of the patients' backgrounds, zygomycosis is much rarer than invasive aspergillosis. In addition to well known immunosuppressive risk factors (hematological malignancy, hematopoietic stem cell or solid organ transplant, prolonged neutropenia, corticosteroid, etc), diabetic ketoacidosis, iron overload, and administration of deferoxamine are specific factors predisposing zygomycosis. Rhinocerebral, pulmonary and disseminated disease is characteristic forms. The mainstay of the treatment is surgical resection, reversal of immunosuppressive factors, and administration of high-dose amphotericin B or its liposomal formulation. Because of the difficulty of culture detection and the absence of reliable serological diagnostic methods, premortem diagnosis and no delaying of effective treatment remain a challenge to physicians.
接合菌病是一种由属于接合菌纲的丝状真菌（根霉属、毛霉属、小克银汉霉属等）引起的侵袭性真菌感染，死亡率极高。尽管接合菌病在生态特征和患者背景方面存在相似之处，但其比侵袭性曲霉病更为罕见。除了众所周知的免疫抑制危险因素（血液系统恶性肿瘤、造血干细胞或实体器官移植、长期中性粒细胞减少、使用皮质类固醇等）外，糖尿病酮症酸中毒、铁过载和去铁胺的使用是导致接合菌病的特定因素。鼻脑型、肺型和播散型疾病是其特征性表现形式。治疗的主要方法是手术切除、逆转免疫抑制因素以及使用高剂量两性霉素B或其脂质体制剂。由于培养检测困难且缺乏可靠的血清学诊断方法，生前诊断以及不延误有效治疗对医生来说仍然是一项挑战。
