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一名男孩以皮肤毛霉病为1型糖尿病的首发表现——病例报告及文献复习

Cutaneous mucormycosis as a presenting feature of type 1 diabetes in a boy - case report and review of the literature.

作者信息

Jevalikar Ganesh, Sudhanshu Siddhnath, Mahendru Sanjay, Sarma Smita, Farooqui Khalid J, Mithal Ambrish

机构信息

Division of Endocrinology and Diabetes, Medanta Medicity Hospital, Gurugram (Haryana), India.

Department of Endocrinology, Sanjay Gandhi PostGraduate Institute of Medical Sciences, Lucknow (Uttar Pradesh), India.

出版信息

J Pediatr Endocrinol Metab. 2018 Jun 27;31(6):689-692. doi: 10.1515/jpem-2017-0404.

Abstract

BACKGROUND

Mucormycosis is a potentially fatal complication of diabetes. The rhino-orbito-cerebral form is the most common presentation, however, rarely other types can also be seen.

CASE PRESENTATION

We describe the case of a 4½ -year-old boy not previously known to be a diabetic who presented to the plastic surgery department for gangrene of the left middle finger with surrounding erythema and induration. After the diagnosis of diabetes and initial treatment, pus from the wound showed broad aseptate hyphae suggestive of mucormycosis which was further confirmed on culture. Aggressive surgical debridement including amputation, antifungal treatment and glycemic control achieved a complete cure.

CONCLUSIONS

Cutaneous mucormycosis is a rare complication of type 1 diabetes mellitus and can even be seen at the onset of diabetes. High index of suspicion, timely antifungal treatment and aggressive surgical debridement usually lead to recovery in the localized form of the disease.

摘要

背景

毛霉菌病是糖尿病的一种潜在致命并发症。鼻眶脑型是最常见的表现形式,不过,也很少能见到其他类型。

病例报告

我们描述了一名4岁半男孩的病例,此前不知其患有糖尿病,他因左手中指坏疽伴周围红斑和硬结而就诊于整形外科。在诊断出糖尿病并进行初步治疗后,伤口脓液显示出提示毛霉菌病的宽大无隔菌丝,培养结果进一步证实了这一诊断。积极的手术清创,包括截肢、抗真菌治疗和血糖控制,实现了完全治愈。

结论

皮肤毛霉菌病是1型糖尿病的一种罕见并发症,甚至可在糖尿病发病时出现。高度的怀疑指数、及时的抗真菌治疗和积极的手术清创通常会使疾病的局限性形式得以康复。

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