Sharma Shefali K, Balasubramanian Prasanth, Radotra Bishan, Singhal Manphool
Department of Internal Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, Candigarh, India.
Department of Internal Medicine, Post graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India.
BMJ Case Rep. 2018 Feb 8;2018:bcr-2017-223243. doi: 10.1136/bcr-2017-223243.
Mucormycosis, a rare opportunistic infection seen in immunocompromised hosts, is caused by fungi of Mucorales family. It may be confined to the organs, such as rhinocerebral and pulmonary mucormycosis, or may cause disseminated infection. A 14-year-old boy presented to our clinic with fever and left upper quadrant abdominal pain, and on evaluation was found to have pancytopaenia, and imaging revealed ill-defined splenic collection with thrombus in the splenic vein. He was started on empirical intravenous antibiotics, followed by antifungals empirically as he did not show any improvement clinically. Eventually, splenectomy was done, which on histopathological examination revealed mucormycosis. The patient finally succumbed to his illness as he developed peritonitis and refractory shock. To date, only two cases of isolated splenic mucormycosis have been reported. Aggressive treatment is needed, which includes the use of antifungals (amphotericin B) and surgical debridement or resection of the involved tissues or organs.
毛霉菌病是一种在免疫功能低下宿主中出现的罕见机会性感染，由毛霉科真菌引起。它可能局限于某些器官，如鼻脑型和肺型毛霉菌病，也可能导致播散性感染。一名14岁男孩因发热和左上腹腹痛前来我院就诊，经评估发现全血细胞减少，影像学检查显示脾脏有边界不清的病灶，脾静脉有血栓形成。开始给予经验性静脉抗生素治疗，由于临床症状无改善，随后经验性给予抗真菌药物治疗。最终进行了脾切除术，组织病理学检查显示为毛霉菌病。患者最终因并发腹膜炎和难治性休克而死亡。迄今为止，仅报道过两例孤立性脾脏毛霉菌病病例。需要积极治疗，包括使用抗真菌药物（两性霉素B）以及对受累组织或器官进行手术清创或切除。
