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在一家三级牙科医疗机构报告的颌面部区域新冠相关毛霉菌病的风险因素、临床影像学表现评估

Evaluation of risk factors, clinico-radiographic presentations of COVID-associated mucormycosis in the maxillofacial region reporting to a tertiary care dental facility.

作者信息

Agarwal Varsha, Gupta Ambika, Singh Virendra, Kumia Komal, Saini Bhawna, Suriya N

机构信息

Dept. of Oral Medicine and Radiology, Post Graduate Institute of Dental Sciences, Rohtak, India.

Dept. of Oral and Maxillofacial Surgery, Post Graduate Institute of Dental Sciences, Rohtak, India.

出版信息

J Oral Biol Craniofac Res. 2023 May-Jun;13(3):412-417. doi: 10.1016/j.jobcr.2023.04.002. Epub 2023 Apr 21.

DOI:10.1016/j.jobcr.2023.04.002
PMID:37274089
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10233207/
Abstract

PURPOSE

To evaluate the prevalence of risk factors associated with COVID-associated mucormycosis (CAM) in the maxillofacial region with emphasis on clinical and radiological characteristics of the disease reporting to the dentists.

METHODS

Archival records of the patients diagnosed with rhino-cerebral mucormycosis through histopathology or culture, were screened and 266 records were included. These records were divided into three groups-previously diabetic (PD, n = 122), recently diagnosed diabetic (RD, n = 105) and non-diabetic (ND, n = 39). All the records were evaluated and compared among the three groups for the duration of presentation, history of co-existing medical conditions, the association of treatment given during COVID-19, and the clinical and radiographic presentations of the disease.

RESULTS

The results confirmed uncontrolled diabetes mellitus as the major risk factor for the disease. The prevalence of steroid administration was lower in our study in contrast to previous literature. The risk factors and treatment rendered during COVID-19 did not differ significantly among the three groups (p > 0.05). The findings indicate that the disease was milder and progressed more slowly in the ND group, both clinically and radiographically, and it had close resemblance to odontogenic infection.

CONCLUSION

Patients with early CAM mimicked the odontogenic infection and were more likely to report in a dental setup. Hence, a multidisciplinary and holistic management approach is necessary.

摘要

目的

评估颌面部与新冠相关毛霉菌病(CAM)相关危险因素的患病率,重点关注向牙医报告的该疾病的临床和放射学特征。

方法

筛选通过组织病理学或培养诊断为鼻脑毛霉菌病患者的档案记录,纳入266份记录。这些记录分为三组——既往糖尿病患者(PD,n = 122)、近期诊断为糖尿病的患者(RD,n = 105)和非糖尿病患者(ND,n = 39)。对所有记录进行评估,并在三组之间比较就诊时间、并存疾病史、新冠疫情期间所接受治疗的相关性以及该疾病的临床和影像学表现。

结果

结果证实未控制的糖尿病是该疾病的主要危险因素。与既往文献相比,我们研究中类固醇给药的患病率较低。三组之间在新冠疫情期间的危险因素和所给予的治疗无显著差异(p > 0.05)。研究结果表明,该疾病在非糖尿病组中临床和影像学表现均较轻且进展较慢,与牙源性感染非常相似。

结论

早期CAM患者表现类似牙源性感染,更有可能在牙科机构就诊。因此,多学科和整体管理方法是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d70/10233207/acaca2ce2e68/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d70/10233207/cbb878b4f3cb/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d70/10233207/64c385e77c45/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d70/10233207/acaca2ce2e68/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d70/10233207/cbb878b4f3cb/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d70/10233207/64c385e77c45/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d70/10233207/acaca2ce2e68/gr2.jpg

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Emerg Infect Dis. 2023 Jan;29(1):8-19. doi: 10.3201/eid2901.220926.
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Post-COVID mucormycosis osteomyelitis and its imaging manifestations in the North of Iran: case series.伊朗北部 COVID 后毛霉菌骨髓炎及其影像学表现:病例系列。
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Hyperglycemia and steroid use increase the risk of rhino-orbito-cerebral mucormycosis regardless of COVID-19 hospitalization: Case-control study, India.
高血糖和类固醇的使用增加了 rhino-orbito-cerebral mucormycosis 的风险,与 COVID-19 住院无关:病例对照研究,印度。
PLoS One. 2022 Aug 8;17(8):e0272042. doi: 10.1371/journal.pone.0272042. eCollection 2022.
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Let's talk about sex characteristics-As a risk factor for invasive fungal diseases.让我们谈谈性特征——作为侵袭性真菌病的一个风险因素。
Mycoses. 2022 Jun;65(6):599-612. doi: 10.1111/myc.13449. Epub 2022 May 25.
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Definition, diagnosis, and management of COVID-19-associated pulmonary mucormycosis: Delphi consensus statement from the Fungal Infection Study Forum and Academy of Pulmonary Sciences, India.COVID-19 相关肺毛霉菌病的定义、诊断和管理:印度真菌感染研究论坛和肺病科学院的德尔菲共识声明。
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The emergence of COVID-19 associated mucormycosis: a review of cases from 18 countries.COVID-19 相关毛霉病的出现:来自 18 个国家的病例回顾。
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