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新冠病毒感染后,在未控制的糖尿病患者中因滥用糖皮质激素和抗生素导致的致命性毛霉病

Fatal Mucormycosis Post COVID-19 Infection in Uncontrolled Diabetes with Misuse of Glucocorticoids and Antibiotics.

作者信息

Hamed Heba, Madia Raed, Ladadweh Hosniyeh, Falana Hiba, AbuKhalil Abdallah Damin

机构信息

Palestine Medical Complex, Ministry of Health, Ramallah, Palestine.

Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine.

出版信息

Infect Drug Resist. 2022 Mar 18;15:1121-1126. doi: 10.2147/IDR.S356465. eCollection 2022.

Abstract

BACKGROUND

Mucormycosis is a fulminant and rapidly progressing fungal infection associated with a high mortality rate. Mucormycosis is primarily seen in immunocompromised patients, especially those with uncontrolled diabetes mellitus (DM), and recently in coronavirus disease 2019 (COVID-19) patients.

CASE PRESENTATION

In this case report, we present a rare case of fatal mucormycosis in Palestine. A 34-year-old Palestinian female patient presented to the emergency department one-month post-COVID-19 infection with left facial pain. During her hospital stay, she deteriorated, with a random blood sugar level of 400 mg/dl and a hemoglobin A1c of 18% with metabolic acidosis and the appearance of swelling and black eschar on her left side of her face. Finally, she was diagnosed with mucormycosis and expired two days later.

CONCLUSION

In this unfortunate case report of mucormycosis, severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection, delayed diagnosis, misuse of corticosteroids, inappropriate use of antibiotics, and uncontrolled diabetes with ketoacidosis contributed to patient mortality and fatality. Therefore, appropriate patient assessment, rapid diagnosis, and selection of appropriate treatment are important and lifesaving.

摘要

背景

毛霉病是一种暴发性且进展迅速的真菌感染,死亡率很高。毛霉病主要见于免疫功能低下的患者,尤其是那些糖尿病控制不佳的患者,最近在2019冠状病毒病(COVID-19)患者中也有发现。

病例报告

在本病例报告中,我们呈现了巴勒斯坦一例罕见的致命性毛霉病病例。一名34岁的巴勒斯坦女性患者在感染COVID-19一个月后因左侧面部疼痛就诊于急诊科。在住院期间,她病情恶化,随机血糖水平为400mg/dl,糖化血红蛋白为18%,伴有代谢性酸中毒,左侧面部出现肿胀和黑色焦痂。最终,她被诊断为毛霉病,并于两天后死亡。

结论

在这份不幸的毛霉病病例报告中,严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染、诊断延误、皮质类固醇的不当使用、抗生素的不合理使用以及伴有酮症酸中毒的糖尿病控制不佳导致了患者的死亡。因此,对患者进行适当评估、快速诊断并选择合适的治疗方法非常重要且能挽救生命。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a2f/8939863/71fc1d445bc6/IDR-15-1121-g0001.jpg

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