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人类免疫缺陷病毒感染个体中的毛霉菌病:病例报告的系统评价

Mucormycosis in Human Immunodeficiency Virus-Infected Individuals: A Systematic Review of Case Reports.

作者信息

Muthu Valliappan, Agarwal Ritesh, Dhooria Sahajal, Sehgal Inderpaul Singh, Prasad Kuruswamy Thurai, Rudramurthy Shivaprakash Mandya, Aggarwal Ashutosh, Chakrabarti Arunaloke

机构信息

Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

出版信息

Mycopathologia. 2023 Oct;188(5):755-763. doi: 10.1007/s11046-023-00775-5. Epub 2023 Jul 27.

Abstract

Mucormycosis in human immunodeficiency virus (HIV) infection is uncommon; notably, many cases have additional predisposing factors. Whether mucormycosis differs in HIV-affected individuals with and without additional risk factors (e.g., neutropenia, diabetes mellitus, and transplantation) remains unclear. In this systematic review, we identified 94 cases of HIV and mucormycosis classifiable into three groups: (1) HIV with additional risk factors (n = 50), (2) intravenous drug users (IVDU, n = 24), and (3) no other risk factor (n = 19) for mucormycosis. The most common presentation in IVDU was renal (41.7%) and cerebral mucormycosis (39.2%), whereas rhino-orbital mucormycosis (ROM, 4.2%) was uncommon. In the other two groups, ROM was the most common presentation. Rhizopus was the most frequently isolated Mucorales; however, in IVDU, Lichtheimia was the most common. The overall mortality was 53% and not significantly different in the three groups. Mucormycosis in HIV-infected individuals is rare without additional risk factors or IVDU.

摘要

人类免疫缺陷病毒(HIV)感染患者发生毛霉病并不常见;值得注意的是,许多病例还有其他易感因素。在有和没有其他危险因素(如中性粒细胞减少、糖尿病和移植)的HIV感染个体中,毛霉病是否存在差异仍不清楚。在这项系统评价中,我们确定了94例HIV合并毛霉病的病例,可分为三组:(1)有其他危险因素的HIV感染者(n = 50),(2)静脉吸毒者(IVDU,n = 24),以及(3)无其他毛霉病危险因素者(n = 19)。IVDU中最常见的表现是肾脏毛霉病(41.7%)和脑部毛霉病(39.2%),而鼻眶毛霉病(ROM,4.2%)并不常见。在其他两组中,ROM是最常见的表现。根霉是最常分离出的毛霉目真菌;然而,在IVDU中,犁头霉是最常见的。总体死亡率为53%,三组之间无显著差异。在没有其他危险因素或IVDU的HIV感染个体中,毛霉病很少见。

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