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印度古吉拉特邦一家三级医疗中心的毛霉菌病

Mucormycosis at a tertiary care centre in Gujarat, India.

作者信息

Patel Atul K, Patel Ketan K, Patel Kamlesh, Gohel Swati, Chakrabarti Arunaloke

机构信息

Infectious Diseases Clinic, "VEDANTA" Institute of Medical Sciences, Ahmedabad, India.

Department of Microbiology, Sterling Hospital, Ahmedabad, India.

出版信息

Mycoses. 2017 Jun;60(6):407-411. doi: 10.1111/myc.12610. Epub 2017 Mar 9.

Abstract

The prevalence of mucormycosis is reportedly high in India, although the studies are mainly from north and south India only. We analysed the mucormycosis cases at tertiary care centres of West India. We retrieved the clinical details of all the patients with probable and proven mucormycosis diagnosed at Sterling Hospital and ID clinic at Ahmedabad, Gujarat over the period from 1 January 2013 through 30 April 2015. The data were analysed to determine demography, risk factors, underlying diseases, site of infection and outcome of these patients. A total of 27 patients with the median age of 50 (16-65) years were diagnosed with mucormycosis during the period. Rhino-orbital-cerebral mucormycosis was the most common (51.9%) presentation. Majority (55.6%) of the patients had uncontrolled diabetes with or without ketoacidosis; 25.9% patients had no underlying disease and most of them (85.7%) had cutaneous mucormycosis. In this group, the mortality was 25.9% and an equal percentage of patients were lost to follow up; 14 (51.9%) patients could complete 6 weeks of amphotericin B therapy. All patients who completed antifungal therapy survived except one. Like other parts of India, uncontrolled diabetes was the predominant risk factor for mucormycosis in our group. Patients completing 6 weeks of amphotericin B treatment were likely to survive.

摘要

据报道,毛霉菌病在印度的患病率很高,不过相关研究主要仅来自印度北部和南部。我们分析了印度西部三级医疗中心的毛霉菌病病例。我们检索了2013年1月1日至2015年4月30日期间在古吉拉特邦艾哈迈达巴德的斯特林医院和ID诊所确诊的所有疑似和确诊毛霉菌病患者的临床细节。对这些数据进行分析,以确定这些患者的人口统计学特征、风险因素、基础疾病、感染部位和治疗结果。在此期间,共有27例患者被诊断为毛霉菌病,中位年龄为50(16 - 65)岁。鼻眶脑型毛霉菌病是最常见的表现形式(51.9%)。大多数(55.6%)患者患有未得到控制的糖尿病,伴有或不伴有酮症酸中毒;25.9%的患者无基础疾病,其中大多数(85.7%)患有皮肤毛霉菌病。在这组患者中,死亡率为25.9%,失访患者的比例与之相同;14例(51.9%)患者能够完成6周的两性霉素B治疗。除1例患者外,所有完成抗真菌治疗的患者均存活。与印度其他地区一样,未得到控制的糖尿病是我们研究组中毛霉菌病的主要风险因素。完成6周两性霉素B治疗的患者有可能存活。

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