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[糖尿病患者的肺毛霉病:药物治疗下的良好转归]

[Pulmonary mucormycosis in a patient with diabetes mellitus: favorable evolution under medical treatment].

作者信息

Strazza Luciana R, Guzman José, Ghelli Raúl E, Carrizo Silvia, Zaya Alejandro, Cazaux Alexis, Cambursano Victor H

机构信息

Residencia en Clínica Médica, Hospital Rawson, Bajada Pucará 2025, Bo Crisol, CP 5000, Córdoba, Argentina.

出版信息

Rev Fac Cien Med Univ Nac Cordoba. 2007;64(3):93-8.

Abstract

Pulmonary mucormycosis is a relatively uncommon but an important opportunistic fungal infection in immunocompromised patients. It may be acquired by inhalation of spores into the lungs. The pathogenic hallmark of mucormycosis is vascular invasion resulting in thrombosis and tissue infarction/necrosis. The diagnosis can be difficult since presentation does not differ from other forms of pneumonia. Risk factors include neutropenia, haematologic malignancies, uncontrolled diabetes mellitus, skin burns and deferoxamine therapy in dialysis patients. Early recognition, control of underlying diseases and medical-surgical aggressive management are warranted to better outcomes. Pulmonary mucormycosis has a high mortality and medical treatment strategy alone has been associated in several studies to greater mortality. We describe a case of pulmonary mucormicosis with favorable evolution only under medical treatment. We reviewed the bibliography.

摘要

肺毛霉病是一种相对罕见但在免疫功能低下患者中很重要的机会性真菌感染。它可能通过吸入孢子进入肺部而获得。毛霉病的致病标志是血管侵袭,导致血栓形成和组织梗死/坏死。由于其临床表现与其他形式的肺炎无异,诊断可能会很困难。危险因素包括中性粒细胞减少、血液系统恶性肿瘤、未控制的糖尿病、皮肤烧伤以及透析患者的去铁胺治疗。早期识别、控制基础疾病以及积极的内科-外科治疗对于取得更好的预后是必要的。肺毛霉病死亡率很高,多项研究表明仅采用药物治疗策略会导致更高的死亡率。我们描述了一例仅通过药物治疗就取得良好转归的肺毛霉病病例。我们还查阅了相关文献。

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