Pilmis Benoit, Lanternier Fanny, Lortholary Olivier
Université Paris-Descartes, Hôpital Necker-Enfants malades, Service des maladies infectieuses et tropicales, Centre d'Infectiologie Necker-Pasteur, Paris, France.
Med Sci (Paris). 2013 Mar;29 Spec No 1:25-30. doi: 10.1051/medsci/201329s106. Epub 2013 Mar 13.
Mucormycosis is a life-threatening invasive fungal infection that arises among immunocompromised patients (haematological malignancies, solid organ transplantation, diabetes mellitus). The most frequent sites of infection are pulmonary, rhinocerebral, cutaneous and disseminated. Reversal of the underlying conditions is mandatory for controlling mucormycosis. Another cornerstone of mucormycosis treatment is prompt and aggressive surgery. It is achieved by extensive surgical debridement of necrotic tissues. Finally an antifungal therapy is needed. The first-line chemotherapy of mucormycosis includes high-dose liposomal amphotericin B (≥ 5 mg/kg/day). The duration of antifungal chemotherapy is not defined but guided by the resolution of all associated symptoms and findings (usually 6-8 weeks). Maintenance therapy/secondary prophylaxis by posaconazole has to be considered in persistently immuno compromised patients.
毛霉病是一种危及生命的侵袭性真菌感染，多发生于免疫功能低下的患者（血液系统恶性肿瘤、实体器官移植、糖尿病）。最常见的感染部位是肺部、鼻脑、皮肤和播散性感染。控制毛霉病必须扭转潜在疾病状况。毛霉病治疗的另一个基石是迅速且积极的手术治疗。这通过广泛手术清除坏死组织来实现。最后还需要抗真菌治疗。毛霉病的一线化疗包括高剂量脂质体两性霉素B（≥5毫克/千克/天）。抗真菌化疗的疗程尚无明确规定，但以所有相关症状和体征的缓解情况为指导（通常为6 - 8周）。对于持续免疫功能低下的患者，必须考虑采用泊沙康唑进行维持治疗/二级预防。
