Czech Mary M, Cuellar-Rodriguez Jennifer
National Institute of Allergy and Infectious Diseases, National Institutes of Health, 10 Center Drive, Building 10 2C146B, Bethesda, MD 20892, USA.
Transplant Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
Infect Dis Clin North Am. 2025 Mar;39(1):121-144. doi: 10.1016/j.idc.2024.11.008. Epub 2024 Dec 4.
Mucormycosis is an aggressive and frequently lethal disease. Most patients with mucormycosis have poorly controlled diabetes mellitus and rhino-orbito-cerebral disease. Patients with hematologic malignancy and transplant recipients mostly present with rhino-orbito-cerebral or pulmonary disease. Prompt recognition of clinical symptoms and radiographic features of mucormycosis is required to establish timely diagnosis and initiate targeted therapy. Diagnosis is, historically, made by direct microscopy, culture, and pathology of biopsy tissue, but molecular methods are increasingly playing a role in establishing an earlier diagnosis. Treatment is multidisciplinary, involving early surgical intervention, antifungal therapy, and correction of underlying immune compromising risk factors when possible.
毛霉病是一种侵袭性且常致命的疾病。大多数毛霉病患者患有控制不佳的糖尿病以及鼻眶脑型疾病。血液系统恶性肿瘤患者和移植受者大多表现为鼻眶脑型或肺型疾病。需要迅速识别毛霉病的临床症状和影像学特征,以便及时确诊并启动针对性治疗。从历史上看,诊断是通过对活检组织进行直接显微镜检查、培养和病理检查来进行的,但分子方法在更早诊断方面正发挥着越来越重要的作用。治疗是多学科的,包括早期手术干预、抗真菌治疗,并尽可能纠正潜在的免疫受损风险因素。