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眼睑皮肤毛霉菌病经皮下注射脂质体两性霉素 B 治疗。

Cutaneous Mucormycosis of the Eyelid Treated With Subcutaneous Liposomal Amphotericin B Injections.

机构信息

The Pacific Center for Oculofacial and Aesthetic Plastic Surgery, San Francisco, California, U.S.A.

California Pacific Medical Center, San Francisco, California, U.S.A.

出版信息

Ophthalmic Plast Reconstr Surg. 2024;40(2):e42-e45. doi: 10.1097/IOP.0000000000002545. Epub 2023 Nov 23.

Abstract

Cutaneous mucormycosis is a rare, opportunistic fungal infection that typically affects immunocompromised hosts. Current treatment consists of systemic antifungal therapy, surgical debridement, and when applicable, restoration of immune function. Despite intervention, the morbidity and mortality of invasive fungal disease remains high. There are few reports of primary or secondary cutaneous mucormycosis involving the ocular adnexa. The authors describe the course of 2 children with cutaneous mucormycosis of the eyelid treated with subcutaneous liposomal amphotericin B (LAmB) injections (3.5 mg/ml) in an off-label application as an adjunct to debridement and systemic antifungal therapy. To the authors' knowledge, these are the first 2 cases of invasive fungal disease involving the eyelid treated with subcutaneous LAmB injections, and the first reported case of disseminated fungal infection with secondary cutaneous involvement of the eyelid.

摘要

皮肤毛霉菌病是一种罕见的、机会性真菌感染,通常影响免疫功能低下的宿主。目前的治疗方法包括全身抗真菌治疗、手术清创,以及在适用的情况下恢复免疫功能。尽管进行了干预,侵袭性真菌感染的发病率和死亡率仍然很高。涉及眼部附属器的原发性或继发性皮肤毛霉菌病的报告很少。作者描述了 2 例眼睑皮肤毛霉菌病患儿的病程,他们接受了皮下脂质体两性霉素 B(LAmB)注射(3.5mg/ml),作为清创和全身抗真菌治疗的辅助手段,这种应用属于超适应证用药。据作者所知,这是首例使用皮下 LAmB 注射治疗眼睑侵袭性真菌病的病例,也是首例报道的伴有眼睑继发性皮肤受累的播散性真菌感染病例。

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