Rasse M, Male O, Knosp E
Universitätsklinik für Kiefer- und Gesichtschirurgie, Wien.
Wien Klin Wochenschr. 1990 Jul 13;102(14):395-403.
According to the literature and on the basis of the case reported in this paper of rhinocerebral mucoraceae mycosis we summarize the characteristic features as follows: mucoraceae--mycoses--common, but wrong term: "mucormycoses"--are a group of infections caused by members of the family mucoraceae (Mucor, Rhizomucor, Rhizopus, Absidia species)--most frequently by Rhizopus species. Primarily the fungi enter the pharynx or nose, local infections or trauma being a prerequisite. The most important predisposing factor is diabetes mellitus. Invading the tissue and causing vascular thrombosis the infection frequently takes an acute, often fulminating and fatal course. Acute sinusitis accompanied by swelling of the cheek and protrusion of the eye in a diabetic, particularly with acidosis, are pathognomonic. Diagnosis is confirmed by microscopic examination of infected tissue (unstained smear or histologically). Since systemically administered antifungals have not proved very effective in these myoses, mainly because an adequate tissue level can hardly be achieved, the most effective and curative treatment is surgical removal of infected tissue, simultaneous control of diabetes being mandatory.
根据文献并基于本文所报道的鼻脑毛霉科真菌病病例，我们将其特征总结如下：毛霉科真菌病——真菌病——常见，但术语“毛霉病”有误——是由毛霉科成员（毛霉属、根毛霉属、根霉属、犁头霉属菌种）引起的一组感染——最常见的是根霉属菌种。真菌主要通过咽部或鼻腔进入人体，局部感染或创伤是前提条件。最重要的诱发因素是糖尿病。感染侵入组织并导致血管血栓形成，通常呈急性病程，往往迅猛且致命。糖尿病患者出现急性鼻窦炎并伴有脸颊肿胀和眼球突出，尤其是伴有酸中毒时，具有诊断意义。通过对感染组织进行显微镜检查（未染色涂片或组织学检查）来确诊。由于全身应用抗真菌药物在这些真菌病中并未证明非常有效，主要是因为难以达到足够的组织药物浓度，最有效且能治愈的治疗方法是手术切除感染组织，同时必须控制糖尿病。
