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与全球 COVID-19 大流行相关的毛霉病感染 - 一项机构组织病理学研究。

Mucormycosis infection associated with global COVID-19 pandemic - an institutional histopathological study.

机构信息

Department of Oral and Maxillofacial Pathology and Microbiology Pt. Bhagwat Dayal Sharma University of Health Sciences Post Graduate Institute of Dental Sciences (PGIDS) Rohtak, Haryana-124001, India

出版信息

Med Oral Patol Oral Cir Bucal. 2023 Mar 1;28(2):e99-e107. doi: 10.4317/medoral.25130.

Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) in the recent times have instilled signs of immunosuppression globally which has further precipitated increasing range of opportunistic infections. Mucormycosis is a distressing opportunistic fungal infection with a high incidence and is the third commonest acute invasive infection following candidiasis and aspergillosis. The aim of the present observational study is to delineate the enigmatic histopathological profile between mucormycosis cases seen prior to pandemic (PPM) and pandemic associated mucormycosis (PAM).

MATERIAL AND METHODS

Tissue archives of 105 histopathologically diagnosed cases of mucormycosis were included and analysed for demographical details and histopathological parameters like fungal load and localization, granuloma formation, necrosis, inflammatory infiltrate and tissue invasion.

RESULTS

0ut of 105 included cases, 11/105 (10.48%) were reported PPM and 94/105 (89.52%) PAM. Among 94 cases of PAM, 51/94 (54%) cases also showed COVID-19 positivity, while 43/94 (46%) did not. Of all the histological variables, increased fungal load and necrosis were observed in PAM relative to PPM cases.

CONCLUSIONS

The histopathological variables like fungal load, necrosis, granuloma formation and tissue invasion, could help the clinician in assessing the clinical status at the time of tissue diagnosis and improve the treatment accordingly.

摘要

背景

最近,2019 年冠状病毒病(COVID-19)在全球范围内引发了免疫抑制迹象,这进一步加剧了机会性感染的范围。毛霉菌病是一种令人痛苦的机会性真菌感染,发病率高,是继念珠菌病和曲霉菌病之后第三常见的急性侵袭性感染。本观察性研究的目的是描绘大流行前(PPM)和大流行相关毛霉菌病(PAM)之间神秘的组织病理学特征。

材料和方法

纳入了 105 例组织病理学诊断为毛霉菌病的病例进行分析,包括人口统计学细节和组织病理学参数,如真菌负荷和定位、肉芽肿形成、坏死、炎症浸润和组织浸润。

结果

在纳入的 105 例病例中,11/105(10.48%)为 PPM,94/105(89.52%)为 PAM。在 94 例 PAM 中,51/94(54%)例也显示 COVID-19 阳性,而 43/94(46%)例没有。在所有组织学变量中,与 PPM 病例相比,PAM 中观察到真菌负荷和坏死增加。

结论

真菌负荷、坏死、肉芽肿形成和组织浸润等组织病理学变量可以帮助临床医生在组织诊断时评估临床状况,并相应地改善治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71ff/9985935/ddd55af6b9fa/medoral-28-e99-g001.jpg

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