Brusis T, Rister M
HNO. 1986 Jun;34(6):262-6.
A twelve year old boy with acute lymphoblastic leukemia was treated with combination chemotherapy. Two weeks later a cellulitis of the left upper and lower eyelid appeared, followed by a rapidly increasing, deep necrotic inflammation of the periorbital area leading to proptosis. Mucormycosis was identified by histology and microbiology. The spreading inflammatory process was arrested by amphotericin B in a total dose of 1.2 g combined with a drainage of the necrotic tissue of the paranasal sinus, left orbit and bifrontal cerebral abscess. The patient is still in complete continuous remission four years later but a large defect of the nasal, maxillary and orbital area remains. This case demonstrates that the usual fatal outcome of mucormycosis in leukemia is curable with amphotericin B and aggressive surgery.
一名12岁急性淋巴细胞白血病男孩接受了联合化疗。两周后,左上、下眼睑出现蜂窝织炎,随后眶周区域迅速出现进行性加深的坏死性炎症,导致眼球突出。通过组织学和微生物学检查确诊为毛霉菌病。使用总量为1.2g的两性霉素B联合鼻窦、左眼眶和双额叶脑脓肿坏死组织引流,阻止了炎症的蔓延。四年后,患者仍处于完全持续缓解状态,但鼻、上颌和眼眶区域仍有大面积缺损。该病例表明,白血病患者毛霉菌病通常的致命结局可通过两性霉素B和积极的手术治愈。