Division of Infectious Diseases, Department of Internal Medicine, Duke University Medical Center, Hanes House, Duke University Medical Center, 315 Trent Drive, Durham, NC 27710, USA.
Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Health System, F4005 UH-South- SPC 5226, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA.
Infect Dis Clin North Am. 2021 Jun;35(2):435-452. doi: 10.1016/j.idc.2021.03.009.
Mucormycosis is a rare but aggressive fungal disease that mainly affects patients with poorly controlled diabetes mellitus and those who are severely immunocompromised, including patients with hematological malignancies and solid organ transplant recipients. Early recognition of infection is critical for treatment success, followed by prompt initiation of antifungal therapy with lipid formulation amphotericin B. Posaconazole and isavuconazole should be used for stepdown and salvage therapy. Surgical debridement is key for tissue diagnosis and treatment and should be pursued urgently whenever possible. In addition to surgery and antifungal therapy, reverting the underlying risk factor for infection is important for treatment response.
毛霉菌病是一种罕见但侵袭性很强的真菌感染，主要影响血糖控制不佳的糖尿病患者和严重免疫功能低下者，包括血液恶性肿瘤患者和实体器官移植受者。早期识别感染对于治疗成功至关重要，随后应立即使用脂质体两性霉素 B 进行抗真菌治疗。泊沙康唑和伊曲康唑应用于降阶梯和挽救治疗。手术清创是组织诊断和治疗的关键，应尽可能紧急进行。除了手术和抗真菌治疗外，纠正感染的潜在危险因素对于治疗反应也很重要。
