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一名肝硬化患者的毛霉菌病病例经泊沙康唑成功治疗并复习文献

A mucormycosis case in a cirrhotic patient successfully treated with posaconazole and review of published literature.

机构信息

Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

Mycopathologia. 2012 Dec;174(5-6):499-504. doi: 10.1007/s11046-012-9561-8. Epub 2012 Jun 29.

Abstract

Mucormycosis is an invasive fungal infection associated with a high mortality rate, especially in immunocompromised hosts. Mucormycosis rarely occurs in cirrhotic patients. Here, we report a case of mucormycosis with underlying liver cirrhosis and diabetes mellitus. The patient suffered from maxillary sinusitis and osteomyelitis, and the infection was successfully treated with antifungal agents, surgical debridement, and hyperbaric oxygen therapy. The antifungal treatments used were liposomal amphotericin B, itraconazole, and posaconazole. Although our patient had liver cirrhosis (Child-Pugh classification B), no hepatic decompensation was developed during the treatment course of posaconazole. This is the first report of the safe and effective use of posaconazole for the treatment of mucormycosis in a cirrhotic patient.

摘要

毛霉菌病是一种侵袭性真菌感染,死亡率很高,尤其是在免疫功能低下的宿主中。毛霉菌病在肝硬化患者中很少见。在这里,我们报告了一例合并肝硬化和糖尿病的毛霉菌病病例。该患者患有上颌窦炎和骨髓炎,经抗真菌药物、手术清创和高压氧治疗后感染得到成功控制。使用的抗真菌药物包括脂质体两性霉素 B、伊曲康唑和泊沙康唑。尽管我们的患者有肝硬化(Child-Pugh 分级 B),但在泊沙康唑治疗过程中没有出现肝功能失代偿。这是首例关于在肝硬化患者中使用泊沙康唑治疗毛霉菌病安全有效的报告。

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