Sami Chowdhury Adnan, Rashed Hasan Mostafa, Khan Abed Hussain, Barai Lovely, Arafat Shohael Mahmud
Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Department of Microbiology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine, and Metabolic Disorders, Dhaka, Bangladesh.
IDCases. 2022 Jul 4;29:e01553. doi: 10.1016/j.idcr.2022.e01553. eCollection 2022.
Mucormycosis is a fatal invasive illness most frequently seen in immunocompromised hosts with uncontrolled diabetes, hematological malignancies, organ transplantation, or long-term steroid treatment. It has a poorer outcome than other fungal diseases due to its rapid spread and resistance to antifungal agents. We report a rare case of disseminated mucormycosis including the bone marrow, peritoneum, lung, and lymph nodes in an apparently immunocompetent 58-year-old gentleman who presented with two months of ascites and weight loss. After a thorough analysis, we found aseptate fungal hyphae in the bone marrow and ascitic fluid. In addition, a cottony white, woolly growth indicative of mucor species was seen in the ascitic fluid culture. CT scans of the chest and abdomen indicate characteristics consistent with mucor invasion. We began the patient on tablet posaconazole, but he died on the fifth day. The atypical presentation in an apparently immunocompetent patient and broad dissemination with rare bone marrow involvement emphasizes the disease's invasiveness.
毛霉病是一种致命的侵袭性疾病，最常见于患有未控制的糖尿病、血液系统恶性肿瘤、器官移植或长期接受类固醇治疗的免疫功能低下宿主。由于其迅速扩散和对抗真菌药物耐药，其预后比其他真菌疾病更差。我们报告了一例罕见的播散性毛霉病病例，累及一名58岁看似免疫功能正常的男性的骨髓、腹膜、肺和淋巴结，该患者出现腹水和体重减轻达两个月。经过全面分析，我们在骨髓和腹水中发现了无隔真菌菌丝。此外，在腹水培养中可见棉絮状白色、羊毛状生长，提示为毛霉属菌种。胸部和腹部CT扫描显示的特征与毛霉侵袭相符。我们让患者开始服用泊沙康唑片，但他在第五天死亡。该病例在看似免疫功能正常的患者中表现不典型，且广泛播散并罕见累及骨髓，凸显了该疾病的侵袭性。
