Thomson S R, Bade P G, Taams M, Chrystal V
Department of Surgery, University of Natal Medical School, South Africa.
Br J Surg. 1991 Aug;78(8):952-4. doi: 10.1002/bjs.1800780819.
Twenty patients with gastrointestinal mucormycosis are reviewed. This often fatal opportunistic fungal infection was diagnosed histologically, and was categorized as colonization (five patients), infiltration (seven patients), or vascular invasion (eight patients). There were no fatalities from colonization. In 10 patients, mucormycosis complicated peptic ulcer disease. Seven of these patients had infiltrative or invasive disease. The presentation and operative findings mimicked malignancy in five of these seven patients, and six had successful surgical intervention. The other patient was cured by medical therapy alone. Ten patients had infection associated with other gastrointestinal diseases: post-traumatic peritonitis (four patients), transmural amoebiasis (two patients), tuberculosis (one patient), gastroenteritis (one patient), gastric carcinoma (one patient) and diabetes (one patient). Eight patients had significant infection and only one survived. In this series, mucormycosis had a less aggressive course when complicating peptic ulcer than when it occurred in association with other gut diseases.
对20例胃肠道毛霉菌病患者进行了回顾性研究。这种往往致命的机会性真菌感染通过组织学诊断,并分为定植(5例患者)、浸润(7例患者)或血管侵袭(8例患者)。定植患者无死亡病例。10例患者中,毛霉菌病并发消化性溃疡病。其中7例患者患有浸润性或侵袭性疾病。这7例患者中有5例的临床表现和手术所见类似恶性肿瘤,6例接受了成功的手术干预。另1例患者仅通过药物治疗治愈。10例患者的感染与其他胃肠道疾病相关:创伤后腹膜炎(4例患者)、透壁性阿米巴病(2例患者)、结核病(1例患者)、胃肠炎(1例患者)、胃癌(1例患者)和糖尿病(1例患者)。8例患者发生严重感染,仅1例存活。在本系列研究中,毛霉菌病并发消化性溃疡时的病程比与其他肠道疾病相关时的病程侵袭性要小。