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一例报告:鼻-眶-脑毛霉菌病的临床特征、诊断和治疗。

A case report on clinical features, diagnosis, and treatment of rhino-orbito-cerebral mucormycosis.

机构信息

Department of Opthalmology, Shanxi Provincial People's Hospital, Taiyuan, China.

出版信息

Immun Inflamm Dis. 2023 Nov;11(11):e1080. doi: 10.1002/iid3.1080.

Abstract

BACKGROUND

Rhino-orbito-cerebral mucormycosis (ROCM) is an opportunistic pathogenic fungal disease caused by the fungus mucor, and it is a life-threatening fungal infection. The ulceration on the skin of the head and neck, accompanied by rhinitis, headache, orbital inflammation, and eyelid edema, should raise a high suspicion of Mucor infection in diabetic patients with inadequately controlled blood glucose.

CASE DESCRIPTION

The clinical data of a patient with ROCM were analyzed retrospectively, and the clinical features were analyzed. The patient was admitted to the hospital with "diabetic hyperosmotic coma" after presenting with fatigue, poor appetite, and disturbances in consciousness as initial symptoms. After improving relevant examinations, controlling underlying diseases, and administering antifungal treatment, the final clinical outcome was death.

CONCLUSION

ROCM is more prevalent in patients with uncontrolled diabetes and varied clinical manifestations. The characteristic feature is an eschar-like necrosis of the local skin or mucosa. The gold criteria for diagnosis are pathology and fungal culture; imaging examination does not reveal any specific manifestations. Early diagnosis and effective treatment are the keys.

摘要

背景

Rhino-orbito-cerebral mucormycosis(ROCM)是一种由真菌毛霉引起的机会性致病真菌病,是一种危及生命的真菌感染。糖尿病患者血糖控制不佳时,出现头颈部皮肤溃疡,伴有鼻炎、头痛、眼眶炎症和眼睑水肿,应高度怀疑毛霉感染。

病例描述

回顾性分析 1 例 ROCM 患者的临床资料,分析其临床特点。患者以“糖尿病高渗性昏迷”为首发症状,表现为乏力、食欲差、意识障碍,入院后完善相关检查,控制基础疾病,给予抗真菌治疗,最终临床结局为死亡。

结论

ROCM 多见于血糖控制不佳的糖尿病患者,临床表现多样。特征性表现为局部皮肤或黏膜的焦痂样坏死。金标准诊断为病理学和真菌培养;影像学检查无特异性表现。早期诊断和有效治疗是关键。

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