Bialek R, Zelck U E
LADR GmbH MVZ Dr. Kramer & Kollegen, Geesthacht, Lauenburger Str. 67, 21502, Geesthacht, Deutschland,
Pathologe. 2013 Nov;34(6):511-8. doi: 10.1007/s00292-013-1831-9.
Mucormycosis is characterized by a rapid, often fatal progression. Early diagnosis of invasive mucormycosis is the key for timely therapeutic intervention and improved survival. Contrary to the more prevalent aspergillosis, effective antifungal therapy of mucormycosis is mainly limited to amphotericin B. Given the importance to guide the timely initiation of amphotericin B and possible surgical intervention, rapid and specific identification of fungal hyphae is essential. Conventional histopathology depends on abundance and morphology of the fungi as well as on the skills of the personnel, and usually shows an accuracy of 80 %. PCR assays targeting fungal ribosomal genes to identify Mucorales at least at genus level increase sensitivity, allow a rapid identification as well as detection of double mold infections. Thus, PCR assays are beneficial to complement existing approaches. They are recommended to rapidly specify tissue diagnosis and accurate identification of fungi. This will help to guide effective therapy and thereby, survival will increase. Retrospective analyses of mucormycosis by PCR help to evaluate therapeutic interventions and will optimize treatment options.
毛霉病的特点是进展迅速,往往致命。侵袭性毛霉病的早期诊断是及时进行治疗干预和提高生存率的关键。与更为常见的曲霉病不同,毛霉病的有效抗真菌治疗主要限于两性霉素B。鉴于指导及时开始使用两性霉素B和可能进行手术干预的重要性,快速、特异性地鉴定真菌菌丝至关重要。传统组织病理学取决于真菌的数量和形态以及人员的技术,通常准确率为80%。针对真菌核糖体基因以至少在属水平鉴定毛霉目的PCR检测提高了敏感性,允许快速鉴定以及检测双重霉菌感染。因此,PCR检测有助于补充现有方法。建议使用它们来快速明确组织诊断并准确鉴定真菌。这将有助于指导有效治疗,从而提高生存率。通过PCR对毛霉病进行回顾性分析有助于评估治疗干预措施并优化治疗方案。