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肝移植术后患者侵袭性肺毛霉菌病坏死性筋膜炎的积极治疗

Aggressive Management of Pulmonary Mucormycosis Necrotizing Fasciitis in a Post-Liver Transplant Patient.

作者信息

Chandra Shivam, Moza Marc, Hubbard Ryan, Bishop Michael

机构信息

General Surgery, A.T. Still University School of Osteopathic Medicine in Arizona, Mesa, USA.

Osteopathic Medicine, A.T. Still University School of Osteopathic Medicine in Arizona, Mesa, USA.

出版信息

Cureus. 2025 Feb 6;17(2):e78649. doi: 10.7759/cureus.78649. eCollection 2025 Feb.

Abstract

Pulmonary mucormycosis (PM) is a severe fungal infection that predominantly affects immunocompromised and diabetic individuals, and it is associated with a high mortality rate, particularly in cases of disseminated disease. We present the case of a 29-year-old liver transplant recipient who developed aggressive PM, confirmed through bronchoalveolar lavage. Treatment involved liposomal amphotericin B, followed by surgical debridement and right pneumonectomy. Despite these interventions, persistent infection required an Eloesser flap procedure for enhanced drainage. This case underscores the importance of early diagnosis and aggressive, multidisciplinary treatment approaches, including surgery and antifungal therapy, to improve outcomes in immunocompromised patients facing this life-threatening condition.

摘要

肺毛霉病(PM)是一种严重的真菌感染,主要影响免疫功能低下者和糖尿病患者,并且与高死亡率相关,尤其是在播散性疾病的病例中。我们报告了一例29岁的肝移植受者发生侵袭性肺毛霉病的病例,该病例通过支气管肺泡灌洗得以确诊。治疗包括脂质体两性霉素B,随后进行手术清创和右肺切除术。尽管采取了这些干预措施,但持续感染仍需要进行埃洛塞尔皮瓣手术以加强引流。该病例强调了早期诊断以及积极的多学科治疗方法(包括手术和抗真菌治疗)对于改善面临这种危及生命状况的免疫功能低下患者的治疗效果的重要性。

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