Larkin J G, Butcher I G, Frier B M, Brebner H
Diabet Med. 1986 May;3(3):266-8. doi: 10.1111/j.1464-5491.1986.tb00760.x.
A 48-year-old male developed fever and sore throat while in Spain and was admitted to hospital, dehydrated, ketotic, pyrexial, and with a blood glucose of 35 mmol/l. Despite treatment with intravenous fluids, insulin, cephalosporin, potassium and bicarbonate he returned to Britain 7 days later, underhydrated and acidotic, though euglycaemic. His face was discoloured, there was painless nasal and maxillary swelling, oral candidiasis, and he went on to develop ophthalmoplegia and sudden blindness. Staphylococcus albus and mycelial fungus were isolated, the latter was identified as Mucor hiemalis, but despite treatment with amphotericin B co-ordinated with radical maxillary-facial surgery he died 31 days after the initial symptoms. Rhinocerebral mucormycosis is a recognized complication of ketoacidosis which is rarely reported in the UK. The organism invades arteries aggressively, therefore radical therapy must be started early to prevent the high mortality.
一名48岁男性在西班牙时出现发热和咽痛，随后入院，存在脱水、酮症、发热，血糖为35 mmol/L。尽管接受了静脉补液、胰岛素、头孢菌素、钾和碳酸氢盐治疗，但7天后他返回英国时仍存在水合不足和酸中毒，不过血糖正常。他面部变色，有无痛性鼻和上颌肿胀、口腔念珠菌病，随后出现眼肌麻痹和突然失明。分离出了白色葡萄球菌和丝状真菌，后者被鉴定为冬孢毛霉，但尽管在进行上颌面部根治手术的同时使用两性霉素B治疗，他在出现初始症状31天后仍死亡。鼻脑毛霉病是酮症酸中毒的一种公认并发症，在英国很少有报道。该病原体积极侵袭动脉，因此必须尽早开始根治性治疗以防止高死亡率。
