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新冠疫情期间不同部位毛霉菌病的临床病理研究

Clinicopathological Study of Mucormycosis at Varied Sites During the COVID-19 Pandemic.

作者信息

Potti Ramya, Mullagura Anusha, Venkata Renuka Inuganti, Shaik Rizwana, Bhavani A Alluri

机构信息

Pathology, NRI Medical College, Guntur, IND.

出版信息

Cureus. 2024 Oct 18;16(10):e71815. doi: 10.7759/cureus.71815. eCollection 2024 Oct.

Abstract

BACKGROUND

Mucormycosis, also known as black fungus, is a rare but serious fungal infection caused by mucor that belongs to Zygomycotic species. Mucor is characterized by non-septate, irregularly wide hyphae with right-angle branching. Mucor can infect different systems of the body and manifest differently depending on the location of the infection, which includes pulmonary, gastrointestinal, rhino-cerebral, and cutaneous.

AIM

The study aims to analyze the incidence, clinical history, and microscopic features associated with mucormycosis in the COVID-19 pandemic at our institute.

MATERIALS AND METHODS

This is a prospective study conducted in the Department of Pathology for three years from March 2020 to April 2022. The samples were collected from different clinical departments mostly from Surgery and Radiology. These samples were fixed in 10% formalin, processed, stained with hematoxylin and eosin (H&E) and were analysed.

RESULTS

A total of 69 cases were included in the study. The age range was 25-80 years and male preponderance was seen with an M:F ratio of 2.6:1. Diabetes was the most common risk factor seen in 53 (77%) cases followed by post-COVID-19 status in 49 (71%) cases. The most common site was paranasal sinuses (58, 84%) followed by orbit (eight, 11%) and two (2.8%) cases each of lung and bone. Fifty (72.4%) cases showed necrosis and 10 (14.5%) cases showed granulomatous inflammation. Angioinvasion was seen in 27 (39%) cases, bony invasion was seen in 26 (37.6%) cases and perineural invasion was seen in one (1.4%) case. We had three (4.3%) cases of mixed fungal infection (mucor and Aspergillus).

CONCLUSION

This study describes the clinical site of presentation and histopathological features of mucormycosis.

摘要

背景

毛霉病,也称为黑真菌病,是一种由属于接合菌纲的毛霉引起的罕见但严重的真菌感染。毛霉的特征是无隔膜、菌丝宽度不规则且呈直角分支。毛霉可感染身体的不同系统,并根据感染部位表现出不同症状,包括肺部、胃肠道、鼻脑和皮肤感染。

目的

本研究旨在分析我院在新冠疫情期间毛霉病的发病率、临床病史及微观特征。

材料与方法

这是一项于2020年3月至2022年4月在病理科进行的为期三年的前瞻性研究。样本大多从外科和放射科等不同临床科室收集。这些样本用10%福尔马林固定、处理、苏木精和伊红(H&E)染色并进行分析。

结果

本研究共纳入69例病例。年龄范围为25至80岁,男性居多,男女比例为2.6:1。糖尿病是最常见的危险因素,53例(77%)出现该因素,其次是新冠感染后状态,49例(71%)出现该情况。最常见的部位是鼻窦(58例,84%),其次是眼眶(8例,11%),肺部和骨骼各2例(2.8%)。50例(72.4%)出现坏死,10例(14.5%)出现肉芽肿性炎症。27例(39%)出现血管侵袭,26例(37.6%)出现骨侵袭,1例(1.4%)出现神经周围侵袭。我们有3例(4.3%)混合真菌感染病例(毛霉和曲霉)。

结论

本研究描述了毛霉病的临床表现部位及组织病理学特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1746/11570782/f05af161837f/cureus-0016-00000071815-i01.jpg

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