Internal Medicine, Yale New Haven Health System, New Haven, Connecticut, USA
Department of Internal Medicine, Section of Infectious Disease, Yale New Haven Health System, New Haven, Connecticut, USA.
BMJ Case Rep. 2020 Oct 22;13(10):e236869. doi: 10.1136/bcr-2020-236869.
Mucormycosis is an invasive mould that can cause aggressive infection, particularly in immunocompromised patients. Though oesophageal mucormycosis is relatively rare, it remains an elusive and devastating manifestation of this disease. The management is also challenging, due to surgical morbidity and contraindications such as thrombocytopenia in immunocompromised hosts. In this report, we present the case of a 60-year-old Lebanese man with newly diagnosed acute myeloid leukaemia who developed oesophageal mucormycosis after induction chemotherapy with idarubicin/cytarabine (7+3). The diagnosis was made when the patient developed febrile neutropenia and odynophagia. CT scan of the chest revealed a thickened oesophagus. Oesophagogastroduodenoscopy with biopsy, histopathology and PCR were performed, resulting in the diagnosis of The patient was successfully treated with liposomal amphotericin B and salvage posaconazole therapy without surgical intervention. We reviewed the clinical characteristics of the six published oesophageal mucormycosis reports from the literature.
毛霉菌病是一种侵袭性霉菌，可导致侵袭性感染，尤其是在免疫功能低下的患者中。尽管食管毛霉菌病相对罕见，但它仍然是这种疾病难以捉摸且具有破坏性的表现。由于免疫功能低下宿主存在手术发病率和禁忌症（如血小板减少症），因此治疗也具有挑战性。在本报告中，我们介绍了一位 60 岁的黎巴嫩男子的病例，他被诊断患有新发急性髓系白血病，在接受伊达比星/阿糖胞苷（7+3）诱导化疗后发生食管毛霉菌病。当患者出现发热性中性粒细胞减少症和咽痛时，诊断出该疾病。胸部 CT 扫描显示食管增厚。进行了食管胃十二指肠镜检查和活检、组织病理学和 PCR，诊断为毛霉菌病。患者成功接受了脂质体两性霉素 B 和挽救性泊沙康唑治疗，而无需手术干预。我们回顾了文献中六篇已发表的食管毛霉菌病报告的临床特征。
