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狼疮性肾炎患者的皮肤毛霉病:一例报告并文献复习

Cutaneous mucormycosis in a patient with lupus nephritis: A case report and review of literature.

作者信息

Cheng Wenrong, Wang Guoqin, Yang Min, Sun Lijun, Dong Hongrui, Chen Yipu, Cheng Hong

机构信息

Division of Nephrology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

出版信息

Medicine (Baltimore). 2017 Oct;96(42):e8211. doi: 10.1097/MD.0000000000008211.

Abstract

RATIONALE

Mucormycosis is a rare fungal infection but life-threatening, especially in lupus nephritis (LN). Mucormycosis may manifest as rhino-orbital-cerebral, pulmonary, cutaneous, gastrointestinal, renal, or disseminated forms.

PATIENT CONCERNS

We report a case of a 52-year-old woman with cutaneous mucormycosis infection who was admitted because of LN.

DIAGNOSES

Histopathological analysis of the lesion confirmed the Rhizopus microspores from the family Mucoraceae.

INTERVENTIONS AND OUTCOMES

The mortality of mucormycosis remains unacceptably high. Our patient died at last even with standard therapy (aggressive surgical debridement and anti-mucormycosis drugs).

LESSONS

It is difficult to diagnose because lacking of specific clinical features, it is necessary to identify the susceptible patients, and then make diagnosis rapidly through tissue biopsy. Despite the outcome is poor, aggressive surgical debridement and Amphotericin B/Posaconazole can be effective.

摘要

理论依据

毛霉病是一种罕见但危及生命的真菌感染,尤其是在狼疮性肾炎(LN)患者中。毛霉病可表现为鼻眶脑型、肺型、皮肤型、胃肠型、肾型或播散型。

患者情况

我们报告一例52岁因狼疮性肾炎入院的女性皮肤毛霉病感染病例。

诊断

病变的组织病理学分析证实为毛霉科的微小根霉菌。

干预措施及结果

毛霉病的死亡率仍然高得令人无法接受。即使采用标准治疗(积极的手术清创和抗毛霉病药物),我们的患者最终还是死亡了。

经验教训

由于缺乏特异性临床特征,诊断困难,有必要识别易感患者,然后通过组织活检迅速做出诊断。尽管预后不佳,但积极的手术清创和两性霉素B/泊沙康唑可能有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22d9/5662373/7cf872fcacde/medi-96-e8211-g001.jpg

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