Vainrub B, Macareno A, Mandel S, Musher D M
Policlinica Metropolitana, Caracas, Venezuela.
Am J Med. 1988 Mar;84(3 Pt 1):546-8. doi: 10.1016/0002-9343(88)90282-3.
Two previously healthy men sustained trauma that caused extensive soft tissue damage together with soil contamination. Within three days, rapidly advancing necrosis was observed at the wound margins. Histologic examination revealed the presence of non-septate branching hyphae characteristic of Mucorales within tissues and in the lumen of blood vessels. In one case, the disease was unrecognized until widespread dissemination had taken place, and the patient died; in the other, a cure resulted from aggressive medical and surgical management. Infections due to Mucorales generally occur in immune-compromised hosts. In cases of extensive trauma, inoculation of devitalized tissues with soil may initiate infection by zygomycetes, even in persons whose immunologic status appears to be normal.
两名既往健康的男性遭受创伤,导致广泛的软组织损伤并伴有土壤污染。在三天内,伤口边缘出现迅速进展的坏死。组织学检查显示组织内和血管腔内存在毛霉目特征性的无隔分支菌丝。在一例中,直到疾病广泛播散才被识别,患者死亡;在另一例中,积极的药物和手术治疗取得了治愈效果。毛霉目感染通常发生在免疫功能低下的宿主中。在广泛创伤的情况下,即使免疫状态看似正常的人,用土壤接种失活组织也可能引发接合菌感染。