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牙科诊所中毛霉菌病的诊断与管理:印度口腔健康专业人员指南

Diagnosis and management of mucormycosis in the dental clinic: A guide for oral health professionals in India.

作者信息

Aswal Gunjan S, Rawat Renu, Dwivedi Dhara, Prabhakar Nitin, Kumar K R Vinod

机构信息

School of Dentistry, Faculty of Medical Sciences, The University of West Indies, St Augustine, Trinidad and Tobago.

Private Practitioner, Bangalore, Karnataka, India.

出版信息

J Family Med Prim Care. 2022 Aug;11(8):4293-4298. doi: 10.4103/jfmpc.jfmpc_1373_21. Epub 2022 Aug 30.

Abstract

With the current pandemic raging over the world, science and medicine is faced with hereto with unfought enemies or less fought opponent in the form of viruses and consequently, other biotic entities. While researchers are striving to identify and conquer the variants of COVID-19, other innocuous organisms are raising their ugly heads in the form of opportunistic fungal infections. Mucormycosis/Black Fungus is an invasive opportunistic fungal infection caused by species. It spreads through blood vessels causing thrombosis, ischemia, and necrosis. Population with pre-existing immunocompromised conditions such as Diabetes Mellitus, Malignancy, Long-term immunosuppressant therapy are more susceptible. Mucormycosis associated with Corona Virus Disease-2019 (COVID-19) proved to be catastrophic due to its high mortality rates. Rhino orbital Mucormycosis is the most common form. The primary care physician, being the first and often, (more so in developing countries) and being the only point of contact with a healthcare professional, plays a pivotal role in the diagnosis and management of this condition. The keystone to decreasing mortality is early detection and diagnosis followed by preventive measures to control progression to the brain. A multidisciplinary approach by various specialties is a prerequisite for effective diagnosis and management. Antifungal therapy, surgical debridement, and resection of the affected areas are protocols to be followed. Post-operative defects cause impairment of function, phonetics, and esthetics. Prosthetic rehabilitation of these defects has shown favorable results, especially in the aged and immunocompromised individuals.

摘要

随着当前这场大流行病在全球肆虐,科学和医学面临着前所未有的敌人,或者说是以病毒以及其他生物实体形式出现的较少被对抗的对手。当研究人员努力识别和攻克新冠病毒变种时,其他无害生物正以机会性真菌感染的形式抬头。毛霉菌病/黑真菌病是一种由多种真菌引起的侵袭性机会性真菌感染。它通过血管传播,导致血栓形成、局部缺血和坏死。患有如糖尿病、恶性肿瘤、长期免疫抑制治疗等已有免疫功能低下状况的人群更容易感染。与2019冠状病毒病(COVID-19)相关的毛霉菌病因其高死亡率而被证明具有灾难性。鼻眶毛霉菌病是最常见的形式。初级保健医生作为首先接触患者且往往(在发展中国家更是如此)也是与医疗专业人员的唯一接触点,在这种疾病的诊断和管理中起着关键作用。降低死亡率的关键是早期发现和诊断,随后采取预防措施以控制病情发展至脑部。各专业的多学科方法是有效诊断和管理的先决条件。抗真菌治疗、手术清创以及切除受影响区域是需要遵循的方案。术后缺损会导致功能、语音和美观方面的损害。这些缺损的修复性康复已显示出良好效果,尤其是在老年人和免疫功能低下的个体中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/790d/9638618/33aa6413ade0/JFMPC-11-4293-g001.jpg

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