Ghafur A, Shareek P S, Senthur Nambi P, Vidyalakshmi P R, Ramasubramanian V, Parameswaran Ashok, Thirunarayan M A, Gopalakrishnan R
Department of Infectious Diseases, Apollo Hospitals, Chennai, India.
Department of Pathology, Apollo Hospitals, Chennai, India.
J Assoc Physicians India. 2013 May;61(5):305-8.
Mucormycosis (Zygomycosis) is a life-threatening infection. We attempted to analyse clinical features and risk factors of Mucormycosis cases in a tertiary care referral institution in India, in patients without underlying malignancy.
We retrospectively analyzed data of patients diagnosed as having Mucormycosis over a 10 year period of 2000-2010. Patients with a histopathology report and/or a Microbiology report of Zygomycetes or Mucor from a biopsy specimen were included in the study.
Out of the 27 cases, rhino-orbital/rhino-cerebral involvement occurred in 12 (44.4%) patients, pulmonary involvement in 3 (11.1%) cases, soft tissue involvement in 11 (40.7%) cases and gastrointestinal involvement in one patient (3.7%). Diabetes mellitus is the main risk factor, followed by renal failure and trauma. Mean ESR value of these patients was 118 mm/1 hour. Mean WBC count was 20 x 10(9)/L, and neutrophil count 82%. The mean absolute neutrophil count (ANC) was 16.8 x 10(9)/L.
The interesting finding in our study was the presence of neutrophilic leucocytosis and high ESR in most of the patients. In a predisposed individual, especially in a diabetic, in countries with high environmental fungal burden; presence of high ESR and neutrophilic leucocytosis with a compatible clinical presentation should raise suspicion of Mucormycosis.
毛霉病（接合菌病）是一种危及生命的感染。我们试图分析印度一家三级医疗转诊机构中无潜在恶性肿瘤患者的毛霉病病例的临床特征和危险因素。
我们回顾性分析了2000年至2010年10年间被诊断为毛霉病的患者的数据。研究纳入了有组织病理学报告和/或活检标本中接合菌或毛霉的微生物学报告的患者。
27例患者中，12例（44.4%）发生鼻眶/鼻脑受累，3例（11.1%）发生肺部受累，11例（40.7%）发生软组织受累，1例（3.7%）发生胃肠道受累。糖尿病是主要危险因素，其次是肾衰竭和创伤。这些患者的平均血沉值为118mm/1小时。平均白细胞计数为20×10⁹/L，中性粒细胞计数为82%。平均绝对中性粒细胞计数（ANC）为16.8×10⁹/L。
我们研究中有趣的发现是大多数患者存在嗜中性白细胞增多和血沉升高。在易感个体中，尤其是糖尿病患者，在环境真菌负荷高的国家；血沉升高和嗜中性白细胞增多并伴有相符的临床表现应引起对毛霉病的怀疑。
