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酮症酸中毒患者颅面部真菌性骨髓炎的范围可能预示视神经受累:一例报告。

Extent of craniofacial fungal osteomyelitis in a ketoacidotic patient may predict optic nerve involvement: A case report.

作者信息

Adams Jennifer, Sheikh Khalid N, Bender-Heine Adam

机构信息

School of Medicine, University of Texas Rio Grande Valley, United States of America.

School of Medicine, University of Texas Rio Grande Valley, United States of America.

出版信息

Int J Surg Case Rep. 2022 Jul;96:107299. doi: 10.1016/j.ijscr.2022.107299. Epub 2022 Jun 13.

Abstract

INTRODUCTION

Mucormycosis is an opportunistic mycosis common in poorly-controlled insulin dependent diabetic patients particularly with ketoacidosis. Fungal osteomyelitis is a life-threatening condition affectation of the nose and paranasal sinuses within the orofacial region.

PRESENTATION OF CASE

We present a 63-year-old diabetic male patient with maxillary mucormycotic osteomyelitis threatening his better seeing eye and review the clinical symptoms, relevant imaging, and management.

DISCUSSION

We highlight a rare pattern of craniofacial fungal bone infection with maxillary and orbital involvement that ultimately spared the optic nerve. This case report offers the clinician a review of important clinical and diagnostic findings that can help direct the need for orbital exenteration.

CONCLUSION

Maxillary mucormycotic osteomyelitis is an aggressive infection that needs to be addressed promptly to prevent fatal consequences.

摘要

引言

毛霉菌病是一种机会性真菌病,常见于血糖控制不佳的胰岛素依赖型糖尿病患者,尤其是伴有酮症酸中毒的患者。真菌性骨髓炎是一种危及生命的疾病,可累及口面部区域的鼻子和鼻窦。

病例介绍

我们报告一例63岁的糖尿病男性患者,患有上颌毛霉菌性骨髓炎,威胁到他视力较好的眼睛,并回顾了临床症状、相关影像学检查及治疗情况。

讨论

我们强调了一种罕见的颅面部真菌性骨感染模式,累及上颌和眼眶,但最终未累及视神经。本病例报告为临床医生提供了重要临床和诊断结果的综述,有助于指导是否需要进行眼眶内容物剜除术。

结论

上颌毛霉菌性骨髓炎是一种侵袭性感染,需要及时处理以防止致命后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a500/9240804/de28aea1750a/gr1.jpg

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