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鼻脑型接合菌病:一名无危险因素的儿科心脏病患者的罕见显著表现。

Rhinocerebral zygomycosis: an unusual dramatic presentation in a paediatric cardiac patient without risk factors.

作者信息

Isgrò Giuseppe, Carlucci Concetta, Giamberti Alessandro, Frigiola Alessandro, Ranucci Marco

机构信息

IRCCS Policlinico San Donato, via Morandi, 30, 20097 San Donato Milanese, Italy.

出版信息

Eur Heart J Suppl. 2016 Apr 28;18(Suppl E):E19-E21. doi: 10.1093/eurheartj/suw029. Epub 2016 Apr 29.

DOI:10.1093/eurheartj/suw029
PMID:28533711
Abstract

Mucormycosis is an angioinvasive infection caused by ubiquitous filamentous fungi of the order Mucorales. We describe a case of rhinocerebral mucormycosis presented in a paediatric patient after cardiac surgery correction of a complete atrioventricular canal defect. The rhinocerebral form of mucormycosis in our patient presented as an important epistaxis that needed immediate intubation due to blood inhalation. Furthermore, due to the worsening of pulmonary function, the patient also needed mechanical support with veno-arterial extracorporeal membrane oxygenation. The patient died as a consequence of a disseminated form of fungal infection. We describe our experience of this rare opportunistic infection and we think that early recognition of the disease could help in proper management.

摘要

毛霉病是由毛霉目无处不在的丝状真菌引起的一种血管侵袭性感染。我们描述了一例在小儿患者行完全性房室通道缺损心脏手术矫正后出现的鼻脑型毛霉病病例。我们患者的鼻脑型毛霉病表现为严重鼻出血,因血液吸入需要立即插管。此外,由于肺功能恶化,患者还需要静脉 - 动脉体外膜肺氧合进行机械支持。患者因播散性真菌感染而死亡。我们描述了我们对这种罕见机会性感染的经验,我们认为早期识别该疾病有助于进行适当的管理。

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Rhinocerebral zygomycosis: an unusual dramatic presentation in a paediatric cardiac patient without risk factors.鼻脑型接合菌病:一名无危险因素的儿科心脏病患者的罕见显著表现。
Eur Heart J Suppl. 2016 Apr 28;18(Suppl E):E19-E21. doi: 10.1093/eurheartj/suw029. Epub 2016 Apr 29.
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本文引用的文献

1
Genetic factors in esophageal atresia, tracheo-esophageal fistula and the VACTERL association: roles for FOXF1 and the 16q24.1 FOX transcription factor gene cluster, and review of the literature.食管闭锁、气管食管瘘及VACTERL综合征中的遗传因素:FOXF1及16q24.1 FOX转录因子基因簇的作用,并文献综述
Eur J Med Genet. 2010 Jan-Feb;53(1):6-13. doi: 10.1016/j.ejmg.2009.10.001. Epub 2009 Oct 12.
2
Treatment of zygomycosis: current and new options.毛霉病的治疗:当前及新的选择
J Antimicrob Chemother. 2008 Jan;61 Suppl 1:i35-40. doi: 10.1093/jac/dkm429.
3
In vitro susceptibilities of 217 clinical isolates of zygomycetes to conventional and new antifungal agents.
217株接合菌临床分离株对传统和新型抗真菌药物的体外敏感性
Antimicrob Agents Chemother. 2007 Jul;51(7):2587-90. doi: 10.1128/AAC.00452-07. Epub 2007 Apr 23.
4
Zygomycosis: the re-emerging fungal infection.接合菌病:再度出现的真菌感染
Eur J Clin Microbiol Infect Dis. 2006 Apr;25(4):215-29. doi: 10.1007/s10096-006-0107-1.
5
Epidemiology and outcome of zygomycosis: a review of 929 reported cases.毛霉菌病的流行病学与转归:929例报告病例的综述
Clin Infect Dis. 2005 Sep 1;41(5):634-53. doi: 10.1086/432579. Epub 2005 Jul 29.
6
Novel perspectives on mucormycosis: pathophysiology, presentation, and management.毛霉菌病的新视角:病理生理学、临床表现及治疗
Clin Microbiol Rev. 2005 Jul;18(3):556-69. doi: 10.1128/CMR.18.3.556-569.2005.
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Zygomycetes in human disease.人类疾病中的接合菌纲真菌。
Clin Microbiol Rev. 2000 Apr;13(2):236-301. doi: 10.1128/CMR.13.2.236.