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早期诊断和积极的手术切除对治愈鼻-脑毛霉菌病至关重要:六例报告。

Early diagnosis and aggressive surgical resection matters to cure rhinocerebral mucormycosis: Six case reports.

机构信息

Department of Oral and Maxillofacial Surgery, Hospital Hernán Henriquez Aravena, Manuel Montt 115, Temuco, Chile.

Doctorate Program in Dental Sciences. School of Dentistry, Universidad de Chile, Sergio Livingstone Polhammer 943, Independencia, Santiago, Chile; School of Health Sciences, Dentistry, Universidad Viña del Mar, Diego Portales 90, Viña del Mar, Chile.

出版信息

J Stomatol Oral Maxillofac Surg. 2024 Oct;125(5S2):101898. doi: 10.1016/j.jormas.2024.101898. Epub 2024 May 1.

Abstract

Rhino-cerebral mucormycosis (RM) is a rare and opportunistic fungal infection observed in immune-compromised patients and metabolic imbalances such as Diabetes Mellitus. RM rapidly infiltrates blood vessels, leading to vascular thrombosis, subsequent tissue necrosis, and high mortality rates (23.6-60%). Due to its fast advancement, RM is a life-threatening condition requiring accurate clinical decisions by the medical and surgical teams. Based on the report of six cases, we emphasize the need for an early diagnosis and starting antifungal pharmacological therapy at the slightest suspicion of RM. Moreover, the restitution of metabolic balance and aggressive surgical debridement are vital steps to control RM, reducing the possibility of fatal outcomes.

摘要

鼻-脑毛霉病(RM)是一种罕见的机会性真菌感染,见于免疫功能低下的患者和代谢失衡的患者,如糖尿病。RM 迅速浸润血管,导致血管血栓形成、随后的组织坏死和高死亡率(23.6%-60%)。由于其快速进展,RM 是一种危及生命的疾病,需要医疗和外科团队做出准确的临床决策。基于 6 例病例报告,我们强调需要在怀疑 RM 时尽早诊断并开始抗真菌药物治疗。此外,恢复代谢平衡和积极的手术清创是控制 RM 的关键步骤,可以降低致命结局的可能性。

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