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特发性再生障碍性贫血并发结肠穿孔和毛霉菌病：病例报告

Idiopathic aplastic anemia with concurrent complications of colonic perforation and mucormycosis: Case report.

作者信息

Li Zhou-Ping, Yang Jing-Cheng, Ma Tao, He Xiao-Xu, Gong Yi-Fan, Xue Jing, Xue Xiao-Yan

机构信息

Department of Critical Care Medicine, Aerospace Center Hospital, Beijing, 100049, China.

出版信息

Heliyon. 2024 Jul 3;10(13):e34091. doi: 10.1016/j.heliyon.2024.e34091. eCollection 2024 Jul 15.

DOI:10.1016/j.heliyon.2024.e34091
PMID:39055835
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11269903/
Abstract

We report a case of a 72-year-old female who presented with fever, abdominal pain, and diarrhea accompanied by leukopenia, anemia, and thrombocytopenia. The diagnosis of acute aplastic anemia was confirmed through bone marrow aspiration. Treatment included glucocorticoids, immunoglobulin therapy, and plasma exchange. Subsequently, the patient developed gastrointestinal bleeding and abdominal Computed Tomography (CT) revealed perforation of the transverse colon. Pathological examination of surgically removed diseased tissue confirmed mucor infection. Despite receiving antifungal therapy with amphotericin B, the patient's condition deteriorated due to the sepsis progression. Mucor infection in immunocompromised patients should be vigilant, and early diagnosis may help improve prognosis.

摘要

我们报告一例72岁女性患者，其表现为发热、腹痛、腹泻，并伴有白细胞减少、贫血和血小板减少。通过骨髓穿刺确诊为急性再生障碍性贫血。治疗包括糖皮质激素、免疫球蛋白治疗和血浆置换。随后，患者出现胃肠道出血，腹部计算机断层扫描（CT）显示横结肠穿孔。手术切除病变组织的病理检查证实为毛霉菌感染。尽管接受了两性霉素B抗真菌治疗，但由于脓毒症进展，患者病情恶化。免疫功能低下患者的毛霉菌感染应引起警惕，早期诊断可能有助于改善预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f1c/11269903/d22450778cc2/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f1c/11269903/35406550bbfd/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f1c/11269903/f8fce2c1ad35/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f1c/11269903/d22450778cc2/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f1c/11269903/35406550bbfd/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f1c/11269903/f8fce2c1ad35/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f1c/11269903/d22450778cc2/gr3.jpg

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Infection. 2023 Apr;51(2):407-416. doi: 10.1007/s15010-022-01891-y. Epub 2022 Aug 3.
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Gastrointestinal mucormycosis: A periodic systematic review of case reports from 2015 to 2021.胃肠道毛霉菌病：2015 年至 2021 年病例报告的定期系统回顾。
Microb Pathog. 2022 Feb;163:105388. doi: 10.1016/j.micpath.2022.105388. Epub 2022 Jan 4.
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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.
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