Uludag University Faculty of Medicine, Infectious Diseases and Clinical Microbiology Department, Görükle, Bursa, Turkey.
J Mycol Med. 2013 Sep;23(3):179-84. doi: 10.1016/j.mycmed.2013.06.003. Epub 2013 Jul 12.
Mucormycosis is a rare, invasive and fatal disease that occurs mainly in diabetes mellitus patients with uncontrolled blood glucose levels or in immunocompromised patients. The mortality rate of this disease is as high as 25 to 80%, despite aggressive surgical treatment and antifungal therapy. This high mortality requires alternative treatment approaches. The accepted treatment modality of invasive mucormycosis are amphotericin B lipid formulations. Although echinocandins generally show no activity against Mucorales, it was shown that Rhizopus oryzae expressed the target enzyme for echinocandins, 1,3-beta-glucan synthase. Additionally, there are some experimental studies in a diabetic mouse model and case reports regarding the effects of caspofungin. In this report, we present a rhinocerebral mucormycosis case treated with liposomal amphotericin B and caspofungin. There was regression of the patient's clinical and radiological condition with the addition of caspofungin, but she died due to discontinuation of her treatment and reasons other than mucormycosis.
毛霉菌病是一种罕见的、侵袭性和致命的疾病，主要发生在血糖控制不佳的糖尿病患者或免疫功能低下的患者中。尽管进行了积极的手术治疗和抗真菌治疗，该病的死亡率仍高达 25%至 80%。如此高的死亡率需要替代治疗方法。侵袭性毛霉菌病的公认治疗方式是两性霉素 B 脂质制剂。尽管棘白菌素类一般对毛霉目显示不出活性，但研究表明，米根霉表达棘白菌素类的靶酶，即 1,3-β-葡聚糖合酶。此外，在糖尿病小鼠模型中进行了一些实验研究，并就卡泊芬净的作用报告了一些病例。在本报告中，我们介绍了一例使用两性霉素 B 脂质体和卡泊芬净治疗的鼻脑毛霉菌病病例。加用卡泊芬净后患者的临床和影像学状况有所改善，但她因停止治疗以及毛霉菌病以外的原因而死亡。
