Tiraboschi Iris, Bravo Martín, Fernández Norma, Stecher Daniel, Melero Marcelo, Lasala María
División Infectología, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Argentina.
Medicina (B Aires). 2012;72(1):23-7.
Mucormycosis is an opportunistic infection caused by fungi of the order Mucorales. It is characterized by rapid progression and high morbidity and mortality in the absence of early diagnosis and prompt treatment. It was an infrequent disease, but in recent years, its incidence appears to have increased. The aim of this paper is to report the cases of mucormycosis diagnosed from 1982 to 2010 at the Hospital de Clinicas José de San Martín, University of Buenos Aires. We diagnosed 10 cases of mucormycosis; the first three between 1982 and 2004 and the last 7 between 2005 and 2010. The incidence from 1980 to 2004 was 0.13 patient-years and the frequency 0.1/10 000 discharges (95% CI 0.00- 0.3). In the period 2005 to 2010, the incidence was 0.86 patients per year with 1.1/10 000 discharges (95% CI 0.5-2.4). There was a pulmonary mucormycosis case (in a patient treated with corticosteroids) and nine rhinocerebral cases, two in neutropenic and seven in diabetic patients. The diagnosis was made by observation of cenocytic hyphae in 10/10 patients. Mucorales were recovered in 8/9 cultures (5 Rhizopus spp and 3 Mucor spp.). In one case diagnosis of pulmonary mucormycosis was made post-mortem. Nine patients were treated with amphotericin B deoxycholate (in 3 patients supplemented with liposomal amphotericin B) and surgery. Three patients underwent hyperbaric chamber. Seven patients had favorable outcome. In conclusion, mucormycosis is a rare disease, but its incidence has increased over the past five years. A good evolution of the patients is linked to early diagnosis and treatment.
毛霉病是由毛霉目真菌引起的一种机会性感染。其特点是在缺乏早期诊断和及时治疗的情况下进展迅速,发病率和死亡率高。它曾是一种罕见疾病,但近年来其发病率似乎有所上升。本文旨在报告1982年至2010年在布宜诺斯艾利斯大学何塞·德·圣马丁临床医院诊断出的毛霉病病例。我们诊断出10例毛霉病;前三例在1982年至2004年之间,后七例在2005年至2010年之间。1980年至2004年的发病率为每患者年0.13例,发生率为0.1/10000次出院(95%可信区间0.00 - 0.3)。在2005年至2010年期间,发病率为每年0.86例患者,发生率为1.1/10000次出院(95%可信区间0.5 - 2.4)。有1例肺部毛霉病病例(1例接受皮质类固醇治疗的患者)和9例鼻脑型病例,其中2例为中性粒细胞减少患者,7例为糖尿病患者。10/10例患者通过观察多核菌丝确诊。9份培养物中有8份培养出毛霉目真菌(5株根霉属和3株毛霉属)。1例肺部毛霉病病例在尸检后确诊。9例患者接受了脱氧胆酸盐两性霉素B治疗(3例患者补充了脂质体两性霉素B)并接受了手术。3例患者接受了高压氧舱治疗。7例患者预后良好。总之,毛霉病是一种罕见疾病,但在过去五年中其发病率有所上升。患者的良好转归与早期诊断和治疗有关。