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未控制的糖尿病患者真菌性全鼻窦炎的眼眶并发症

Orbital complications of fungal pan-sinusitis in uncontrolled diabetes.

作者信息

Nicolae Miruna, Popescu Cristian Radu, Popescu Bogdan, Grigore Raluca

机构信息

ENT, Department of Head and Neck Surgery, Coltea Clinic Hospital, Bucharest, Romania.

出版信息

Maedica (Bucur). 2013 Sep;8(3):276-9.

Abstract

The purpose of our clinical case presentation is to emphasize the role of ear, nose and throat specialist in early recognition and urgent treatment of mucormycosis, which is a rare infection caused by fungus belonging to the order Mucorales. They are known opportunistic organisms, which potentially invade and infect a host with depressed immunity. In our paper we present a case of an uncontrolled diabetic male with orbital complications caused by a fungal pan-sinusitis. The typical presentation of rhino-orbital fungal infection is that of anterior orbital inflammation, severe visual loss, external ophthalmoplegia and fever. Our diagnostic was based on an otolaryngological, ophthalmological, imagistic but especially biopsy exam, which is the only one that can make the certain diagnostic in this case. We followed the standard treatment for these situations. Early recognition and treatment with urgent surgical debridement and systemic antifungal therapy is the key to the management of rhino-orbital mucormycosis and is necessary to limit the spread of infection, which can lead to high morbidity and mortality. Therefore, health practitioners should be familiar with the signs and symptoms of the disease.The authors certify that they do not have any financial or personal relationships that might bias the content of this work.

摘要

我们临床病例报告的目的是强调耳鼻喉科专家在毛霉菌病早期识别和紧急治疗中的作用,毛霉菌病是一种由毛霉目真菌引起的罕见感染。它们是已知的机会性生物体,有可能侵入并感染免疫力低下的宿主。在我们的论文中,我们介绍了一例患有真菌性全鼻窦炎并伴有眼眶并发症的未控制糖尿病男性病例。鼻眶真菌性感染的典型表现为眼眶前部炎症、严重视力丧失、眼球外肌麻痹和发热。我们的诊断基于耳鼻喉科、眼科、影像学检查,但尤其是活检检查,活检是唯一能在此病例中做出明确诊断的检查。我们遵循了针对这些情况的标准治疗方法。早期识别并通过紧急手术清创和全身抗真菌治疗是鼻眶毛霉菌病管理的关键,对于限制可能导致高发病率和死亡率的感染扩散是必要的。因此,医疗从业者应熟悉该疾病的体征和症状。作者证明他们不存在任何可能使本作品内容产生偏差的财务或个人关系。

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本文引用的文献

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Mucormycosis.毛霉菌病
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