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解密拔牙术后毛霉菌病的发生:系统评价。

Decrypting the occurrence of mucormycosis following dental extractions: A systematic review.

机构信息

Senior Resident, Department of Dentistry. All India Institute of Medical Sciences. Bhubaneswar, India.

Consultant Dental Surgeon,Ramkrishna Sarada Mission Matri Bhawan, Kolkata, West Bengal, India.

出版信息

J Mycol Med. 2023 May;33(2):101360. doi: 10.1016/j.mycmed.2023.101360. Epub 2023 Feb 11.

Abstract

BACKGROUND

Mucormycosis is a life-threatening opportunistic infection. The present systematic review was done to provide to date summary of the frequency of rhino-orbital-mucormycosis (ROM) cases following a tooth extraction, as there was no systematic review present till now to highlight it.

METHOD

The PubMed, PMC, Google Scholar, and Ovid Embase databases were searched thoroughly with appropriate keywords till April 2022 including the human population with language restrictions including English literature to collate case reports and case series regarding post-extraction Mucormycosis. All the details of the patient's characteristics were extracted and presented as a table and evaluated on different endpoints.

RESULTS

In total, we identified 31 case reports and 1 case series that results in 38 cases with Mucormycosis. The majority of patients belong to India (47. 4%). There was male predominance (68.4%) and involvement of maxilla was the most. Pre-existing diabetes mellitus (DM)(55.3%) was an independent risk factor for mucormycosis. The median period for the onset of symptoms was 30(14-75) days. 21.1% of cases presented signs and symptoms of cerebral involvement allied with DM.

CONCLUSION

Dental extraction can trigger ROM by rupturing the oral mucous membrane. Clinicians should pay attention to the non-healing extraction socket which may be an early clinical manifestation of it, which is the key to tackling this deadlier infection.

摘要

背景

毛霉菌病是一种危及生命的机会性感染。本系统评价旨在提供迄今为止关于拔牙后发生鼻-眶-脑毛霉菌病(ROM)病例的频率总结,因为目前尚无系统评价来强调这一点。

方法

我们彻底搜索了 PubMed、PMC、Google Scholar 和 Ovid Embase 数据库,使用适当的关键词进行搜索,截至 2022 年 4 月,包括英语文献在内的人类人口语言限制,以整理关于拔牙后毛霉菌病的病例报告和病例系列。提取所有患者特征的详细信息,并以表格形式呈现,并在不同的终点进行评估。

结果

共确定了 31 份病例报告和 1 份病例系列,共涉及 38 例毛霉菌病患者。大多数患者来自印度(47.4%)。男性居多(68.4%),上颌受累最常见。预先存在的糖尿病(DM)(55.3%)是毛霉菌病的独立危险因素。症状出现的中位时间为 30(14-75)天。21.1%的病例出现与糖尿病相关的脑受累的体征和症状。

结论

拔牙会通过破裂口腔黏膜引发 ROM。临床医生应注意未愈合的拔牙窝,这可能是其早期临床表现,也是治疗这种更致命感染的关键。

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