Serris Alexandra, Danion François, Lanternier Fanny
Université Paris Descartes, Centre d'Infectiologie Necker Pasteur, IHU Imagine, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France.
Centre National de Référence mycoses invasives et antifongiques, Unité de Mycologie Moléculaire, Institut Pasteur, 75015 Paris, France.
J Fungi (Basel). 2019 Mar 14;5(1):23. doi: 10.3390/jof5010023.
Mucormycosis is an emerging life-threatening fungal infection caused by . This infection occurs mainly in immunocompromised patients, especially with hematological malignancy, transplantation, or diabetes mellitus. Rhino-orbito-cerebral and pulmonary mucormycosis are the predominant forms. Interestingly, location is associated with the underlying disease as pulmonary mucormycosis is more frequent in hematological malignancy patients whereas rhino-orbito-cerebral mucormycosis is associated with diabetes. Cutaneous mucormycosis results from direct inoculation, mainly after trauma or surgery. Gastro-intestinal mucormycosis occurs after ingestion of contaminated food or with contaminated device and involves the stomach or colon. Disseminated disease is the most severe form and is associated with profound immunosuppression. Uncommon presentations with endocarditis, osteoarticluar or isolated cerebral infections are also described. Finally, health-care associated mucormycosis is a matter of concern in premature newborns and burn units. Clinical symptoms and CT scan findings are not specific, only the early reversed halo sign is associated with pulmonary mucormycosis. Circulating DNA detection is a recent promising diagnostic tool that may lead to improving the diagnosis and prompting therapeutic initiation that should include antifungal treatment, correction of the underlying disease and surgery when feasible.
毛霉病是一种由……引起的新出现的危及生命的真菌感染。这种感染主要发生在免疫功能低下的患者中，尤其是患有血液系统恶性肿瘤、接受过移植或患有糖尿病的患者。鼻眶脑型和肺型毛霉病是主要类型。有趣的是，感染部位与基础疾病有关，因为肺型毛霉病在血液系统恶性肿瘤患者中更为常见，而鼻眶脑型毛霉病与糖尿病有关。皮肤毛霉病是由直接接种引起的，主要发生在创伤或手术后。胃肠道毛霉病发生在摄入受污染的食物或使用受污染的器械后，累及胃或结肠。播散性疾病是最严重的形式，与严重的免疫抑制有关。也有关于心内膜炎、骨关节或孤立性脑感染等罕见表现的描述。最后，医疗保健相关的毛霉病是早产儿和烧伤病房关注的问题。临床症状和CT扫描结果并不具有特异性，只有早期的反晕征与肺型毛霉病有关。循环DNA检测是一种近期有前景的诊断工具，可能有助于改善诊断并促使尽早开始治疗，治疗应包括抗真菌治疗、纠正基础疾病以及在可行时进行手术。
