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一名伊朗糖尿病患者的耳软骨创伤性毛霉菌病

Traumatic Mucormycosis of Auricular Cartilage in an Iranian Diabetic Patient.

作者信息

Meidani Mohsen, Abtahi Sayed Hamidreza, Mohammadi Rasoul

机构信息

Department of Infectious Diseases, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Otolaryngology, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Int Med Case Rep J. 2020 Mar 18;13:95-99. doi: 10.2147/IMCRJ.S246072. eCollection 2020.

Abstract

Mucormycosis is an uncommon and acute fungal infection, with high morbidity and mortality. Traumatic mucormycosis mainly occurs in military conflicts, civilian trauma, and vehicle accidents. Hurricanes, tornadoes, floods, and tsunamis also play a major role in causing mucormycosis by inoculation. Herein, we presented a case of trauma-related mucormycosis in a 70-year-old diabetic male. He referred to a specialty clinic due to the auricular swelling after having fallen and having a major trauma in his ear. Pathologic examination of necrotic cartilage revealed broad ribbon like aseptate hyphae. Antifungal therapy with amphotericin B deoxycholate (1.5 mg/kg/day) was administered for 6 weeks as an initial therapy, and the patient was discharged with a regimen of posaconazole oral solution (400 mg PO bid with meals) for 8 weeks. He followed up for one year and there was no recurrence of the infection. In conclusion, traumatic mucormycosis is a rare but potentially life-threatening fungal infection. Early diagnosis and surgical excision are essential regarding the management of this critical condition. Knowing the underlying diseases is preferable to early diagnosis and timely initiation of antifungal therapy in order to improve survival rates.

摘要

毛霉病是一种罕见的急性真菌感染,发病率和死亡率都很高。创伤性毛霉病主要发生在军事冲突、平民创伤和交通事故中。飓风、龙卷风、洪水和海啸通过接种也在引发毛霉病方面起主要作用。在此,我们报告了一例70岁糖尿病男性的创伤相关性毛霉病病例。他因跌倒后耳部严重创伤出现耳部肿胀而转诊至专科诊所。坏死软骨的病理检查显示有宽的带状无隔菌丝。最初给予两性霉素B脱氧胆酸盐(1.5mg/kg/天)抗真菌治疗6周,患者出院时服用泊沙康唑口服溶液(400mg口服,每日两次,与餐同服)8周。他随访了一年,感染没有复发。总之,创伤性毛霉病是一种罕见但可能危及生命的真菌感染。早期诊断和手术切除对于这种危急情况的处理至关重要。了解基础疾病有助于早期诊断并及时开始抗真菌治疗,以提高生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2d1/7090215/11f9f9a6cf6e/IMCRJ-13-95-g0001.jpg

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