Chussi Desderius Celestine, Kayuza Michael, Magwizi Marco, Shija Peter, Sadiq Adnan, Amsi Patrick, Katundu Denis, Mtenga Philbert
Department of Otorhinolaryngology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
SAGE Open Med Case Rep. 2022 Feb 21;10:2050313X221078721. doi: 10.1177/2050313X221078721. eCollection 2022.
Mucormycosis is an acute and aggressive fungal infection usually, but not exclusively, occurring in immunocompromised individuals. Lack of knowledge and awareness in developing countries hinders timely management. This case highlights the importance of a prompt index of suspicion for the timely and aggressive intervention of mucormycosis to the Tanzanian community. We report a case of fatal rhino-orbital-cerebral mucormycosis in a diabetic patient presenting at a tertiary hospital in the Kilimanjaro region, Tanzania. Nasal deformity, proptosis, chemosis and left-sided hemiplegia were evident on physical examination. Nasoendoscopy revealed extensive necrosis of the nasal septum, inferior turbinate and involvement of the frontal recess. Computed tomography and magnetic resonance imaging of the paranasal sinuses and head revealed necrosis and ischemic changes due to fungal invasion. The patient deceased due to intracranial complications of advanced fungal invasion. Late presentation and unacquainted with mucormycosis our patient had an unfavourable outcome. Early diagnosis, extensive surgical debridement and a multidisciplinary approach to treatment are of the essence in favour of a better prognosis.
毛霉菌病是一种急性侵袭性真菌感染，通常（但并非仅）发生于免疫功能低下的个体。发展中国家对该病缺乏了解和认识，这阻碍了及时的治疗。该病例突出了对毛霉菌病及时进行怀疑指数提示以便对坦桑尼亚社区进行及时、积极干预的重要性。我们报告了一例在坦桑尼亚乞力马扎罗地区一家三级医院就诊的糖尿病患者发生的致命性鼻眶脑毛霉菌病。体格检查发现明显的鼻畸形、眼球突出、结膜水肿和左侧偏瘫。鼻内镜检查显示鼻中隔、下鼻甲广泛坏死以及额隐窝受累。鼻窦和头部的计算机断层扫描及磁共振成像显示因真菌侵袭导致的坏死和缺血性改变。患者因晚期真菌侵袭的颅内并发症死亡。由于就诊延迟且对毛霉菌病不了解，我们的患者预后不佳。早期诊断、广泛的手术清创以及多学科治疗方法对于获得更好的预后至关重要。
