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伪装成炎症性肠病的隐匿性侵袭性胃肠道毛霉病:病理学家的观点。

Unsuspected invasive gastrointestinal mucormycosis masquerading as inflammatory bowel disease: A pathologist's perspective.

作者信息

Shankaralingappa Sunitha

机构信息

Department of Pathology, Columbia Asia Hospital, Hebbal, Bengaluru, Karnataka, India.

出版信息

Indian J Pathol Microbiol. 2019 Apr-Jun;62(2):332-334. doi: 10.4103/IJPM.IJPM_240_18.

Abstract

Mucormycosis is caused by fungi of the order Mucorales and class Zygomycetes. It is a rare opportunistic infection frequently associated with immunocompromised status. It can be disseminated disease or localized, which includes rhinocerebral, pulomonary, cutaneous, and gastrointestinal mucormycosis. Gastrointestinal mucormycosis is the most uncommon usually fatal disease accounting for 4-7% of all cases. We present a rare case of unusual presentation of angioinvasive colonic mucormycosis in a seemingly immunocompetent female masquerading as inflammatory bowel disease. It is very important to differentiate between both because treatment with steroids may lead to dissemination of disease ultimately resulting in a fatal outcome. A surgeon should maintain a high index of suspicion as timely appropriate surgical intervention along with effective antifungal treatment remains the cornerstone of treatment for this highly fatal disease. The definitive diagnosis is possible only by histopathological demonstration of tissue invasion. This requires a quantitatively and qualitatively adequate tissue biopsy.

摘要

毛霉病由毛霉目真菌和接合菌纲引起。它是一种罕见的机会性感染,常与免疫功能低下状态相关。它可以是播散性疾病或局限性疾病,包括鼻脑型、肺型、皮肤型和胃肠道毛霉病。胃肠道毛霉病是最不常见的通常致命的疾病,占所有病例的4 - 7%。我们报告一例罕见病例,一名看似免疫功能正常的女性出现血管侵袭性结肠毛霉病,表现不典型,伪装为炎症性肠病。区分两者非常重要,因为使用类固醇治疗可能导致疾病播散,最终导致致命后果。外科医生应保持高度警惕,因为及时适当的手术干预以及有效的抗真菌治疗仍然是这种高度致命疾病治疗的基石。只有通过组织侵袭的组织病理学证明才能做出明确诊断。这需要进行定量和定性足够的组织活检。

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