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免疫功能正常者的鼻眶毛霉菌病:关于艾沙康唑的经验

Rhinoorbital mucormycosis in the immunocompetent: Experience with Isavuconazole.

作者信息

Ilharco Marta, Pereira Carla Maravilha, Moreira Laura, Proença Ana Luísa, do Carmo Fevereiro Maria, Lampreia Fátima, Oliveira Miguel Lopes, Rola José

机构信息

Department of Internal Medicine 1.4, Hospital de S. José - Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.

Department of Radiology, Hospital de Curry Cabral - Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.

出版信息

IDCases. 2019 Jul 9;18:e00591. doi: 10.1016/j.idcr.2019.e00591. eCollection 2019.

Abstract

Mucormycosis is a severe opportunistic fungal infection caused by . The majority of the affected patients have a history of immunosuppression, with a reported incidence of 4-19% in the immunocompetent. Early recognition and diagnosis, combined with surgical debridement and appropriate antifungal therapy are essential to achieve a cure. In this article we report the case of a 61-year-old immunocompetent male who complained with pain in his right eye. After being first diagnosed with conjunctivitis and treated accordingly, he eventually needed surgical debridement and the biopsy showed the presence of fungi of the class . He was submitted to intravenous therapy with Liposomal Amphotericin B (LAmB) and Posaconazole for several days, which was then changed to Isavuconazole due to bicytopenia. He also received treatment with hyperbaric oxygen, achieving altogether good results. He was discharged after eight months, still on oral Isavuconazole 200mg/day and re-evaluated after three and six months, showing no evidence of progression of the infection.

摘要

毛霉菌病是一种由……引起的严重机会性真菌感染。大多数受影响患者有免疫抑制病史,据报道免疫功能正常者的发病率为4% - 19%。早期识别和诊断,结合手术清创和适当的抗真菌治疗对于治愈至关重要。在本文中,我们报告了一例61岁免疫功能正常男性的病例,该患者主诉右眼疼痛。最初被诊断为结膜炎并接受相应治疗后,他最终需要手术清创,活检显示存在……类真菌。他接受了数天的脂质体两性霉素B(LAmB)和泊沙康唑静脉治疗,后因双血细胞减少改为艾沙康唑。他还接受了高压氧治疗,总体取得了良好效果。八个月后出院,仍每日口服200mg艾沙康唑,并在三个月和六个月后进行重新评估,未显示感染进展迹象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a54c/6700484/1079e55094c1/gr1.jpg

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