Fadhel Mustafa, Patel Swapnil V, Liu Edward, Fune Lito, Wasserman Ethan J, Asif Arif
Department of Medicine, Jersey Shore University Medical Center, Neptune, NJ, USA.
Am J Case Rep. 2019 Aug 16;20:1210-1215. doi: 10.12659/AJCR.916864.
BACKGROUND Mucormycosis is a serious, potentially fatal fungal infection caused by species in the Mucorales order. Together with candidiasis and aspergillosis, it is one of the most significant fungal infection that carries a high rate of mortality. Early detection and initiation of antifungal therapy with adequate surgical debridement improves the clinical outcome. CASE REPORT We describe a case of mucormycosis in a patient with acute myeloid leukemia who developed disseminated lung disease with muscular involvement without any cutaneous manifestation. Successful treatment was achieved with surgical debridement, amphotericin B lipid-complex and posaconazole step-down therapy. CONCLUSIONS Mucormycosis can present in various clinical scenarios. Key to diagnosis depends on tissues diagnosis from the affected system, as was done with lung and muscle biopsy in our patient. Clinicians should maintain high suspicion for early diagnosis and prompt treatment.
背景 毛霉病是一种由毛霉目真菌引起的严重的、可能致命的真菌感染。它与念珠菌病和曲霉病一起,是死亡率很高的最重要的真菌感染之一。早期检测并开始抗真菌治疗以及进行充分的手术清创可改善临床结局。病例报告 我们描述了一例急性髓系白血病患者发生毛霉病的病例,该患者出现播散性肺部疾病并累及肌肉,无任何皮肤表现。通过手术清创、两性霉素B脂质体复合物及泊沙康唑降阶梯治疗取得了成功。结论 毛霉病可呈现多种临床情况。诊断的关键取决于对受累系统进行组织诊断,就像我们的患者通过肺和肌肉活检那样。临床医生应高度怀疑以进行早期诊断和及时治疗。