Bonifaz Alexandro, Tirado-Sánchez Andrés, Calderón Luz, Romero-Cabello Raúl, Kassack Juan, Ponce Rosa María, Mena Carlos, Stchigel Alberto, Cano Josep, Guarro Josep
Mycology Department, Dermatology Service, Hospital General de México (HGM), Reus, Spain.
Mycoses. 2014 Dec;57 Suppl 3:79-84. doi: 10.1111/myc.12233. Epub 2014 Aug 31.
We present a single-centre, retrospective study (1985-2012) of 22 cases of mucormycosis in children. A total of 158 mucormycosis cases were identified, of which 22 (13.96%) were children. The mean age of the children was 10.3 years (range: 6 months-18 years), and 59% of the infections occurred in males. The rhinocerebral form was the main clinical presentation (77.27%), followed by the primary cutaneous and pulmonary patterns. The major underlying predisposing factors were diabetes mellitus in 68.18% of the patients and haematologic diseases in 27.7% of the patients. The cases were diagnosed by mycological tests, with positive cultures in 95.4% of the patients. Rhizopus arrhizus was the foremost aetiologic agent in 13/22 cases (59.1%). In 21 cultures, the aetiologic agents were identified morphologically and by molecular identification. In 10 cultures, the internal transcribed spacer region of the ribosomal DNA was sequenced. Clinical cure and mycological cure were achieved in 27.3% cases, which were managed with amphotericin B deoxycholate and by treatment of the underlying conditions.
我们开展了一项针对儿童毛霉菌病的单中心回顾性研究(1985 - 2012年),共纳入22例患儿。总共识别出158例毛霉菌病病例,其中22例(13.96%)为儿童。患儿的平均年龄为10.3岁(范围:6个月至18岁),59%的感染发生在男性患儿中。鼻脑型是主要临床表现(77.27%),其次是原发性皮肤型和肺型。主要潜在诱发因素为糖尿病,占患者的68.18%,血液系统疾病占27.7%。通过真菌学检测确诊病例,95.4%的患者培养结果呈阳性。在22例病例中的13例(59.1%)里,少根根霉是首要病原体。在21份培养物中,通过形态学和分子鉴定确定了病原体。在10份培养物中,对核糖体DNA的内部转录间隔区进行了测序。27.3%的病例实现了临床治愈和真菌学治愈,这些病例采用了去氧胆酸盐两性霉素B治疗并对基础疾病进行了治疗。