采用球后注射两性霉素B辅助治疗鼻眶脑型毛霉菌病（ROCM）及相关脑炎。
Rhino-orbital-cerebral mucormycosis (ROCM) and associated cerebritis treated with adjuvant retrobulbar amphotericin B.
作者信息
Safi Mustafa, Ang Michael J, Patel Poorav, Silkiss Rona Z
机构信息
California Pacific Medical Center, San Francisco, CA, United States.
Silkiss Eye Surgery, San Francisco, CA, United States.
出版信息
Am J Ophthalmol Case Rep. 2020 Jun 6;19:100771. doi: 10.1016/j.ajoc.2020.100771. eCollection 2020 Sep.
PURPOSE
We report a case of rhino-orbital-cerebral mucormycosis (ROCM) with focal anterior cerebritis treated favorably with retrobulbar amphotericin B and systemic antifungals.
OBSERVATIONS
A 55-year-old diabetic male presented to the emergency department with left sided proptosis, left temple headache, maxillary sinus pain, and diplopia of 3 days duration. Biopsy results from the left middle turbinate, ethmoid, and maxillary sinus revealed broad and irregular non-septate hyphae consistent with mucormycosis. Despite treatment with intravenous antifungals and endoscopic debridement of the sinuses, his condition did not improve. Disease progression included the development of left ophthalmoplegia and left-sided cerebritis. The patient received retrobulbar injection of deoxycholate amphotericin B with eventual disease resolution, without exenteration.
CONCLUSIONS
We present a case of ROCM with associated cerebritis that responded to retrobulbar amphotericin B, without exenteration.
目的
我们报告一例眼眶-鼻窦-脑毛霉菌病（ROCM）伴局灶性前脑脑炎患者，经球后注射两性霉素B和全身抗真菌治疗后病情好转。
观察结果
一名55岁的糖尿病男性因左侧眼球突出、左侧颞部头痛、上颌窦疼痛和持续3天的复视就诊于急诊科。左侧中鼻甲、筛窦和上颌窦的活检结果显示有与毛霉菌病相符的粗大且不规则的无隔菌丝。尽管接受了静脉抗真菌治疗和鼻窦内镜清创术，但其病情并未改善。疾病进展包括出现左侧眼肌麻痹和左侧脑脑炎。患者接受了球后注射脱氧胆酸盐两性霉素B治疗，最终疾病得到缓解，未行眶内容剜除术。
结论
我们报告了一例伴有脑脑炎的ROCM病例，该病例对球后注射两性霉素B治疗有反应，未行眶内容剜除术。
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