Steve Anna K, Hurdle Valerie A, Brown Jevon Y
Section of Plastic Surgery, Department of Surgery, University of Calgary, Calgary, Alberta.
Plast Reconstr Surg Glob Open. 2018 Oct 2;6(10):e1927. doi: 10.1097/GOX.0000000000001927. eCollection 2018 Oct.
Mucormycosis is a rare fungal infection caused by ubiquitous fungi in the order Mucorales. It is the most rapidly progressing fulminant fungal infection that mimics necrotizing soft-tissue infections. Overwhelming fungal sepsis develops quickly and mortality rates approach 70%. Culture negative necrotizing infections and cutaneous necrosis following a vascular pattern should raise suspicion for this rare entity. We describe avoiding mortality in a case of orbitomaxillofacial mucormycosis multifactorially treated with: radical serial debridement, topical amphotericin B irrigation and dressings, parenteral amphotericin B, and hyperbaric oxygen therapy. Tissue biopsy was central to confirming the diagnosis and directing multimodal management that ultimately prevented dissemination to the central nervous system and mortality.
毛霉病是一种由毛霉目无处不在的真菌引起的罕见真菌感染。它是进展最迅速的暴发性真菌感染，类似于坏死性软组织感染。严重的真菌败血症发展迅速，死亡率接近70%。培养阴性的坏死性感染以及呈血管分布模式的皮肤坏死应引起对这种罕见疾病的怀疑。我们描述了一例眼眶颌面毛霉病患者通过以下多因素治疗避免死亡：根治性连续清创术、局部两性霉素B冲洗和敷料、静脉注射两性霉素B以及高压氧治疗。组织活检对于确诊和指导多模式治疗至关重要，最终防止了疾病扩散至中枢神经系统并避免了死亡。
