Department of Oral- and Maxillofacial Surgery, Kantonsspital Aarau, Aarau, Switzerland.
Medical Additive Manufacturing Research Group, Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland.
Oral Dis. 2022 Apr;28(3):568-576. doi: 10.1111/odi.13802. Epub 2021 Mar 2.
Rhino-orbito-cerebral mucormycosis (ROCM) is a rare and potentially fatal invasive fungal infection which usually occurs in diabetic and other immunocompromised patients. This infection is associated with high morbidity and mortality rates. Prompt diagnosis and rapid aggressive surgical debridement and antimycotic therapy are essential for the patient's survival. Herein, we reviewed the localization and treatment strategies in patients with ROCM and diabetes as an underlying condition. Furthermore, we report one case of ROCM in our department.
From 117 identified studies published in PubMed, 14 publications-containing data from 54 patients-were included. All patients were diagnosed clinically and by histopathological and/or bacteriological analysis for ROCM caused by the order Mucorales.
Uncontrolled diabetes mellitus is one of the main risk factors for ROCM. A successful management of ROCM requires an early diagnosis, a prompt systemic antifungal therapy, and a rapid aggressive surgical debridement including exploration of the pterygopalatine fossa. An orbital exenteration may be necessary.
Rhino-orbito-cerebral mucormycosis（ROCM）是一种罕见且具有潜在致命性的侵袭性真菌感染，通常发生在糖尿病和其他免疫功能低下的患者中。这种感染与高发病率和死亡率相关。及时诊断和快速积极的手术清创和抗真菌治疗对于患者的生存至关重要。在此，我们回顾了伴有糖尿病的 ROCM 患者的定位和治疗策略。此外，我们还报告了我们科室的一例 ROCM 病例。
从 Pubmed 上已发表的 117 项研究中，共纳入了 14 项包含 54 例患者数据的研究。所有患者均通过临床、组织病理学和/或细菌学分析确诊为 Mucorales 引起的 ROCM。
未控制的糖尿病是 ROCM 的主要危险因素之一。ROCM 的成功治疗需要早期诊断、及时全身抗真菌治疗和快速积极的手术清创，包括翼腭窝的探查。可能需要进行眶内容剜除术。
