Elzein Fatehi, Kalam Kiran, Mohammed Nazik, Elzein Ahmed, Alotaibi Fadhel Zaben, Khan Mujtaba, Albadani Abeer
Infectious Diseases Unit, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia.
Department of Histopathology, PSMMC, Riyadh, Saudi Arabia.
Med Mycol Case Rep. 2018 Oct 28;23:4-7. doi: 10.1016/j.mmcr.2018.10.005. eCollection 2019 Mar.
We report on an elderly male patient with headache and right-side weakness. Imaging studies revealed multiple space-occupying lesions in the parietal and occipital cerebral regions. Biopsy revealed broad aseptate ribbon-like structures branching at right angles, suggestive of mucormycosis. Improvement was observed after medical therapy with 20 weeks of liposomal amphotericin B (5 mg/kg/day) combined with posaconazole, followed by posaconazole (400 mg twice a day) alone for 1 month. The patient recovered without neurological deficits; however, multidrug-resistant bacteraemia and hospital-acquired pneumonia occurred, resulting in death. Nevertheless, our report shows that this lethal fungal infection can sometimes show favourable progress with drug therapy alone.
我们报告了一名患有头痛和右侧肢体无力的老年男性患者。影像学研究显示顶叶和枕叶脑区有多个占位性病变。活检发现有宽的无隔带状结构以直角分支，提示为毛霉菌病。在用脂质体两性霉素B（5毫克/千克/天）联合泊沙康唑治疗20周后，观察到病情改善，随后单独使用泊沙康唑（400毫克，每日两次）治疗1个月。患者康复且无神经功能缺损；然而，发生了多重耐药菌血症和医院获得性肺炎，导致死亡。尽管如此，我们的报告表明，这种致命的真菌感染有时仅通过药物治疗就能显示出良好的进展。
