印度新冠肺炎患者的毛霉菌病:对其发病机制、临床表现及管理策略的见解
Mucormycosis in Indian COVID-19 Patients: Insight into Its Patho-Genesis, Clinical Manifestation, and Management Strategies.
作者信息
Sahu Ram Kumar, Salem-Bekhit Mounir M, Bhattacharjee Bedanta, Almoshari Yosif, Ikbal Abu Md Ashif, Alshamrani Meshal, Bharali Alakesh, Salawi Ahmad, Widyowati Retno, Alshammari Abdulrahman, Elbagory Ibrahim
机构信息
Department of Pharmaceutical Science, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia.
Department of Pharmaceutical Science, Assam University (A Central University), Silchar 788011, India.
出版信息
Antibiotics (Basel). 2021 Sep 6;10(9):1079. doi: 10.3390/antibiotics10091079.
Mucormycosis in patients who have COVID-19 or who are otherwise immunocompromised has become a global problem, causing significant morbidity and mortality. Infection is debilitating and fatal, leading to loss of organs and emotional trauma. Radiographic manifestations are not specific, but diagnosis can be made through microscopic examination of materials collected from necrotic lesions. Treatment requires multidisciplinary expertise, as the fungus enters through the eyes and nose and may even reach the brain. Use of the many antifungal drugs available is limited by considerations of resistance and toxicity, but nanoparticles can overcome such limitations by reducing toxicity and increasing bioavailability. The lipid formulation of amphotericin-B (liposomal Am-B) is the first-line treatment for mucormycosis in COVID-19 patients, but its high cost and low availability have prompted a shift toward surgery, so that surgical debridement to remove all necrotic lesions remains the hallmark of effective treatment of mucormycosis in COVID-19. This review highlights the pathogenesis, clinical manifestation, and management of mucormycosis in patients who have COVID-19.
新型冠状病毒肺炎(COVID-19)患者或其他免疫功能低下患者的毛霉病已成为一个全球性问题,会导致严重的发病率和死亡率。感染会使人虚弱并致命,导致器官丧失和精神创伤。影像学表现不具有特异性,但可通过对从坏死病变处采集的材料进行显微镜检查来做出诊断。由于真菌可通过眼睛和鼻子进入甚至到达脑部,治疗需要多学科专业知识。现有多种抗真菌药物,但耐药性和毒性问题限制了其使用,而纳米颗粒可通过降低毒性和提高生物利用度来克服这些限制。两性霉素B脂质体(liposomal Am-B)是COVID-19患者毛霉病的一线治疗药物,但其高成本和低可及性促使治疗转向手术,因此手术清创以清除所有坏死病变仍是COVID-19患者毛霉病有效治疗的标志。本综述重点介绍了COVID-19患者毛霉病的发病机制、临床表现和治疗。