Mulki Ramzi, Masab Muhammad, Eiger Glenn, Perloff Sarah
Einstein Medical Center, Philadelphia, Pennsylvania, USA.
Division of Infectious Diseases, Einstein Medical Center, Philadelphia, Pennsylvania, USA.
BMJ Case Rep. 2016 Jun 2;2016:bcr2016215855. doi: 10.1136/bcr-2016-215855.
Rhinocerebral mucormycosis (RCM) is an angioinvasive fungal infection most often caused by Rhizopus oryzae It is usually associated with an underlying risk factor and is associated with a poor prognosis. There are no consensus guidelines on the optimal management of this aggressive disease; most management decisions are based on case reports and expert opinion. We report a successfully managed case of RCM in an insulin-dependent diabetic, initially presenting with a change in mental status, rapidly progressing to complete right eye blindness and ophthalmoplegia and complicated by multiple cerebral infarctions and abscesses. We describe the diagnostic approach and various therapeutic interventions undertaken to successfully manage our patient.
鼻脑型毛霉菌病(RCM)是一种血管侵袭性真菌感染,最常见的病因是米根霉。它通常与潜在风险因素相关,且预后较差。对于这种侵袭性疾病的最佳管理,目前尚无共识性指南;大多数管理决策基于病例报告和专家意见。我们报告了一例成功治疗的胰岛素依赖型糖尿病患者的RCM病例,该患者最初表现为精神状态改变,迅速发展为右眼完全失明和眼肌麻痹,并伴有多发性脑梗死和脓肿。我们描述了成功治疗该患者所采用的诊断方法和各种治疗干预措施。