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冠状病毒病大流行期间的毛霉菌病:一种不容错过的诊断。

Mucormycosis during Coronavirus Disease Pandemic: A Diagnosis we Cannot Afford to Miss.

作者信息

Arthanari Kaneesh Karthik, Annamalai Sivakumar, Thangavelu Arthiie, Palanivelu Chandrika, Suresh Gowtham, Anbuselvan Sambavi

机构信息

Department of Oral and Maxillofacial Surgery, JKK Nattraja Dental College, Namakkal, Tamil Nadu, India.

Department of Periodontics, JKK Nattraja Dental College, Namakkal, Tamil Nadu, India.

出版信息

J Pharm Bioallied Sci. 2021 Nov;13(Suppl 2):S1769-S1771. doi: 10.4103/jpbs.jpbs_444_21. Epub 2021 Nov 10.

Abstract

Mucormycosis is a very aggressive, devastating opportunistic fungal infection commonly involving nasal, maxillary,orbital, and cerebral regions. In the second wave of the coronavirus disease 2019 (COVID-19) pandemic, a high frequency of mucormycosis infections has been seen because of the triad of COVID-19, systemic steroids, and preexisting diabetes mellitus. A patient might present with a simple mobile tooth/teeth with multiple gingival abscesses Necrotic bone could be seen in the palate. Blackish discoloration might be present in the oral mucosa. There might be extraoral swelling . If rhino-oculo cerebral mucormycosis is diagnosed, then there are two immediate treatment modalities to be followed. Both surgical and medical treatment are necessary. Surgical is thorough debridement of the necrotic tissue. To prevent the occurrence of mucormycosis, meticulous glycemic control and rational use of steroids and antibiotics for the shortest possible time with adequate attention toward the ventilators and tubing are necessary.

摘要

毛霉菌病是一种极具侵袭性、破坏性的机会性真菌感染,通常累及鼻腔、上颌、眼眶和脑部区域。在2019冠状病毒病(COVID-19)大流行的第二波中,由于COVID-19、全身用类固醇和既往糖尿病这三者的共同作用,毛霉菌病感染的发生率很高。患者可能表现为一颗或多颗活动的牙齿伴有多处牙龈脓肿,腭部可见坏死骨。口腔黏膜可能出现发黑变色。可能存在口外肿胀。如果诊断为鼻-眼-脑型毛霉菌病,那么有两种直接的治疗方式可供采用。手术和药物治疗都很必要。手术是对坏死组织进行彻底清创。为预防毛霉菌病的发生,必须严格控制血糖,尽可能短时间合理使用类固醇和抗生素,并充分注意呼吸机和管道。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71eb/8686934/b515f7260c61/JPBS-13-1769-g001.jpg

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