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唐氏综合征患者合并肠结核和毛霉菌感染:一例独特病例报告并文献复习。

Co-infection of intestinal tuberculosis and mucormycosis in a patient with Down syndrome: a unique case report with literature review.

机构信息

Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Depatment of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Puducherry, India.

出版信息

BMJ Case Rep. 2021 Nov 30;14(11):e244903. doi: 10.1136/bcr-2021-244903.

Abstract

Mucormycosis represents several unusual opportunistic infection caused by saprophytic aseptate fungi. There is a recent rise in cases of mucormycosis due to an increase in diabetic and immunodeficient patients like patients on long-term steroids, immunomodulators due to organ transplantation, malignancies, mainly haematological malignancies, and autoimmunity. Anatomically, mucormycosis can be localised most commonly as rhino-orbito-cerebral followed by pulmonary, disseminated, cutaneous and gastrointestinal, rarest being small intestinal. Patients with Down syndrome are immunodeficient due to their impaired immune response. Disseminated tuberculosis is also common in immunodeficient patients. We report a rare case of small intestinal mucormycosis in a patient with Down syndrome with coexisting intestinal tuberculosis. Due to the invasiveness of mucormycosis, the patient succumbed to death despite providing aggressive surgical debridement and medical management.

摘要

毛霉菌病代表了几种由腐生性无隔真菌引起的罕见机会性感染。由于糖尿病和免疫功能低下患者的增加,如长期使用类固醇、免疫调节剂的患者,由于器官移植、恶性肿瘤,主要是血液恶性肿瘤和自身免疫性疾病,毛霉菌病的病例最近有所增加。解剖学上,毛霉菌病最常见的局部定位是鼻-眶-脑,其次是肺、播散性、皮肤和胃肠道,最罕见的是小肠。唐氏综合征患者由于免疫反应受损而免疫功能低下。免疫功能低下患者也常发生播散性肺结核。我们报告了一例唐氏综合征患者合并肠结核的罕见小肠毛霉菌病病例。由于毛霉菌病的侵袭性,尽管提供了积极的手术清创和药物治疗,患者还是死亡了。

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Epidemiology of Mucormycosis in India.印度毛霉菌病的流行病学
Microorganisms. 2021 Mar 4;9(3):523. doi: 10.3390/microorganisms9030523.
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Ileal Mucormycosis Causing Bleeding in Necrotizing Pancreatitis.回肠毛霉菌病导致坏死性胰腺炎出血
ACG Case Rep J. 2019 Aug 15;6(8):e00165. doi: 10.14309/crj.0000000000000165. eCollection 2019 Aug.
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Jejunal stricture due to mucormycosis.由毛霉菌病引起的空肠狭窄。
Trop Doct. 2019 Oct;49(4):318-320. doi: 10.1177/0049475519864250. Epub 2019 Jul 19.

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