Tuder R M
Mycopathologia. 1985 Feb;89(2):81-8. doi: 10.1007/BF00431474.
A case of myocardium infarction in generalized mucormycosis is reported in a patient suffering from chronic renal failure and receiving a cadaver kidney transplant. At autopsy we found a recent necrotic myocardium, coronary vessels occluded by mucor hyphae and a striking absence of inflammatory cells, chiefly neutrophils. Ultrastructural studies revealed thick-walled fungus that participate in the thrombus and cross the coronary artery in a 'corkscrew' pattern, without important cellular degeneration. Thin-walled irregularly branching structures were observed occluding the microcirculation of still preserved cardiac areas. These structures could be originated from the fungus cells that had lost their thick laminated wall, leaving the plasmatic membrane as external coat. Special emphasis is given to the relation between the poor coronary vascular protection against mucormycosis and the neutrophilic disfunction. The lungs are the main site of primary infection. This disease is underdiagnosed in vivo and leads always to death.
本文报道了一例患有慢性肾功能衰竭并接受尸体肾移植的患者发生全身性毛霉病合并心肌梗死的病例。尸检时，我们发现近期坏死的心肌、被毛霉菌丝阻塞的冠状动脉血管以及显著缺乏炎症细胞（主要是中性粒细胞）的现象。超微结构研究显示，厚壁真菌参与血栓形成，并以“螺旋”模式穿过冠状动脉，未出现重要的细胞变性。观察到薄壁不规则分支结构阻塞了仍保留心肌区域的微循环。这些结构可能源自失去厚层细胞壁、仅留下质膜作为外层包膜的真菌细胞。特别强调了冠状动脉对毛霉病的保护作用差与中性粒细胞功能障碍之间的关系。肺部是原发性感染的主要部位。这种疾病在体内易被漏诊，且总会导致死亡。
