Ristow W, Bohl J, Lange H P, Schober R
HNO. 1979 Feb;27(2):63-8.
A case of mucormycosis in a 45 year-old woman with uncontrolled diabetes is reported. Following dental extractions, the patient presented with total ophthalmoplegia, chemosis and complete sensory loss of the right fifth cranial nerve. Exophthalmus was not present. Although a fungal infection was suspected, administration of Amphotericin B was avoided because of renal insufficiency. After temporary clinical improvement with high doses of antibiotics, signs of right seventh and eighth cranial nerve paralysis and of thrombosis of the right ophthalmic artery developed. The patient expired after six days. Autopsy disclosed extensive mucormycosis with involvement of the nasal cavity and paranasal sinuses, soft tissues and bones of face and orbit, cranial nerves, meninges and base of the brain, as well as mycotic thrombosis of the right cavernous sinus and the internal carotid, ophthalmic and maxillary arteries. The spread of infection is detailed, and the importance of an early diagnosis is stressed.
报告了一例45岁未控制糖尿病女性的毛霉菌病病例。拔牙后，患者出现完全性眼肌麻痹、球结膜水肿及右侧第五颅神经完全感觉丧失。无眼球突出。尽管怀疑有真菌感染，但因肾功能不全未给予两性霉素B治疗。在高剂量抗生素治疗后病情暂时改善，但随后出现右侧第七和第八颅神经麻痹及右侧眼动脉血栓形成的体征。患者在六天后死亡。尸检发现广泛的毛霉菌病，累及鼻腔和鼻窦、面部和眼眶的软组织及骨骼、颅神经、脑膜和脑底部，以及右侧海绵窦和颈内动脉、眼动脉及上颌动脉的霉菌性血栓形成。详细描述了感染的传播情况，并强调了早期诊断的重要性。
