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一名新冠肺炎患者的鼻窦眼眶毛霉菌病:病例报告

Sino-orbital mucormycosis in a COVID-19 patient: A case report.

作者信息

Maini Aastha, Tomar Gaurav, Khanna Deepak, Kini Yogesh, Mehta Hardik, Bhagyasree V

机构信息

Department Of Oral and Maxillofacial Surgery, D. Y. Patil University, Sector 7 Nerul, Navi Mumbai 400706, India.

Department Of Oral and Maxillofacial Surgery, D. Y. Patil University, Sector 7 Nerul, Navi Mumbai 400706, India.

出版信息

Int J Surg Case Rep. 2021 May;82:105957. doi: 10.1016/j.ijscr.2021.105957. Epub 2021 May 4.

Abstract

INTRODUCTION

We report a case of post COVID-19 Sino-orbital Mucormycosis infection caused by Rhizopus oryzae and its management.

PRESENTATION OF CASE

The patient was diagnosed with COVID-19 and treated according to the persisting protocols. Following recovery, on the 18th day, the patient developed chemosis and pain in the left eye. A diagnosis of mucormycosis was established after Magnetic Resonance Imaging (MRI) and Functional Endoscopic Sinus Surgery (FESS). Initially, conservative management with intravenous (IV) Fluconazole & Amphotericin B was done and later on with surgical debridement. The patient recovered with minimal residual deformity.

DISCUSSION

Mucormycosis generally develops secondary to immunosuppression or debilitating diseases. In Head and Neck cases, the mold usually gains entry through the respiratory tract involving the nose and sinuses, with possible further progression into the orbital and intracranial structures. Hence, an early diagnosis and intervention is required for a good prognosis, decreasing the morbidity. This can be achieved on the basis of clinical picture and direct smears.

CONCLUSION

Research needs to be carried out in COVID-19 patients for better prevention and management of opportunistic infections in order to reduce its incidence and morbidity. Prophylactic treatment protocols need to be established, along with rational use of corticosteroids.

摘要

引言

我们报告一例由米根霉引起的新冠病毒感染后眼眶黏液菌病病例及其治疗情况。

病例介绍

该患者被诊断为新冠病毒感染,并按照现行方案进行治疗。康复后,在第18天,患者左眼出现球结膜水肿和疼痛。经磁共振成像(MRI)和功能性鼻内镜鼻窦手术(FESS)后确诊为黏液菌病。最初采用静脉注射氟康唑和两性霉素B进行保守治疗,随后进行手术清创。患者康复,残留畸形最小。

讨论

黏液菌病通常继发于免疫抑制或衰弱性疾病。在头颈部病例中,霉菌通常通过呼吸道进入,累及鼻子和鼻窦,并可能进一步发展至眼眶和颅内结构。因此,为了获得良好的预后并降低发病率,需要早期诊断和干预。这可以根据临床表现和直接涂片来实现。

结论

需要对新冠病毒感染患者进行研究,以更好地预防和管理机会性感染,从而降低其发病率。需要建立预防性治疗方案,同时合理使用皮质类固醇。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/077c/8114123/beb5571e41c8/gr1.jpg

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