Infectious Division, Kashan Shahidbeheshti Hospital, Kashan, Iran.
J Mycol Med. 2013 Jun;23(2):123-9. doi: 10.1016/j.mycmed.2013.04.002. Epub 2013 May 27.
Mucormycosis is an opportunistic fulminant fungal infection, which affects nose and paranasal sinuses by direct invasion or through the blood vessels mainly in diabetic and immunocompromised patients. In the present study, a rhino-orbito-cerebral mucormycosis in a 24-year-old female with diabetes mellitus as underlying disease was reported. Computed tomography (CT scan) demonstrated an increase in the soft tissue densities in the left nasal cavity, maxillary and ethmoid sinuses and destruction of the antral wall with soft tissue densities in the pterygopalatine fossa and retromaxillary fissure. In histopathology, wide ribbon-shape non-septate hyphae were seen in tissue sections stained with hematoxylin-eosin (H&E). The etiologic fungus isolated from tissue biopsy on mycological media was identified by the amplification and sequencing of the 5.8S RNA gene and of the adjacent internal transcriber spacer domains, ITS1/ITS4, as Rhizopous oryzae. Recognition of the unique patterns of this high mortality rhinocerebral fungal infection in patients with diabetes is a key to early diagnosis and successful treatment.
毛霉菌病是一种机会性暴发性真菌感染，主要通过血管或直接侵犯途径影响鼻和鼻旁窦，主要发生于糖尿病和免疫功能低下的患者。本研究报道了一例 24 岁女性糖尿病患者合并发生的鼻-眶-脑毛霉菌病。计算机断层扫描（CT 扫描）显示左侧鼻腔、上颌窦和筛窦软组织密度增加，窦壁破坏，翼腭窝和上颌后窝有软组织密度影。组织病理学检查显示，苏木精-伊红（H&E）染色的组织切片中可见宽带状无隔菌丝。从组织活检中分离出的病原真菌通过 5.8S RNA 基因和相邻的内部转录间隔区 ITS1/ITS4 的扩增和测序鉴定为米根霉。识别糖尿病患者这种高死亡率的鼻-脑真菌性感染的独特模式是早期诊断和成功治疗的关键。
