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肺毛霉病:超越经典的新冠病毒相关真菌感染

Pulmonary Mucormycosis: Beyond Classic COVID-19-Associated Fungal Infections.

作者信息

Pereira Rita, Neves Sara, Ruão Maria, Gonçalves Celina, Teixeira Carla

机构信息

Anesthesiology, Intensive Care and Emergency Department, Centro Hospitalar Universitário de Santo António, Porto, PRT.

Infectious Diseases Department, Centro Hospitalar Universitário de Santo António, Porto, PRT.

出版信息

Cureus. 2024 Jan 24;16(1):e52849. doi: 10.7759/cureus.52849. eCollection 2024 Jan.

DOI:10.7759/cureus.52849
PMID:38406002
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10884720/
Abstract

Coronavirus disease 2019 (COVID-19) is often linked to a broad range of opportunistic bacterial and fungal infections. The second wave of the COVID-19 pandemic has witnessed an unprecedented surge in mucormycosis cases, predominantly in India, while the disease remained relatively rare in Europe. The authors describe the case of a 62-year-old female patient admitted to the hospital for consolidation therapy with chemotherapy as a part of the treatment protocol for acute myeloid leukemia. During hospitalization, she was diagnosed with nosocomial COVID-19, which later progressed to respiratory deterioration. COVID-19 with bacterial superinfection was presumed, leading to the initiation of empirical antibiotic therapy. A bronchoscopy was performed several days later due to a lack of improvement, revealing an infection by the  complex. Despite antifungal treatment, the patient experienced an unfavorable clinical course and ultimately died. Given the high index of suspicion required to diagnose pulmonary mucormycosis, which can lead to delays in appropriate treatment and increase the burden of disease, the authors are aiming to enhance its awareness.

摘要

2019年冠状病毒病(COVID-19)常与多种机会性细菌和真菌感染有关。在第二波COVID-19大流行期间,毛霉菌病病例出现了前所未有的激增,主要集中在印度,而在欧洲该疾病仍然相对罕见。作者描述了一名62岁女性患者的病例,该患者因作为急性髓系白血病治疗方案一部分的化疗巩固治疗而入院。住院期间,她被诊断为医院获得性COVID-19,后来病情进展为呼吸功能恶化。推测为COVID-19合并细菌重叠感染,因此开始经验性抗生素治疗。几天后,由于病情没有改善,进行了支气管镜检查,结果显示感染了 复合体。尽管进行了抗真菌治疗,但患者的临床病程仍不理想,最终死亡。鉴于诊断肺毛霉菌病需要高度怀疑,这可能导致适当治疗的延迟并增加疾病负担,作者旨在提高对此病的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23b0/10884720/7430010b2523/cureus-0016-00000052849-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23b0/10884720/7430010b2523/cureus-0016-00000052849-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23b0/10884720/7430010b2523/cureus-0016-00000052849-i01.jpg

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本文引用的文献

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Invasive Fungal Infections Associated with COVID-19.与新型冠状病毒肺炎相关的侵袭性真菌感染
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Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India.COVID-19 相关毛霉菌病:全球及印度病例报告的系统综述。
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8
ECMM/ISHAM recommendations for clinical management of COVID-19 associated mucormycosis in low- and middle-income countries.ECMM/ISHAM 关于中低收入国家 COVID-19 相关毛霉菌病临床管理的建议。
Mycoses. 2021 Sep;64(9):1028-1037. doi: 10.1111/myc.13335. Epub 2021 Jul 26.
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Epidemiology of Mucormycosis in India.印度毛霉菌病的流行病学
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Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium.全球毛霉病诊断和管理指南:欧洲医学真菌学会联合会与真菌感染研究组教育和研究联盟合作开展的一项倡议。
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