Melnick J Z, Latimer J, Lee E l, Henrich W L
Department of Medicine, University of Texas Southwestern Medical Center, Dallas, USA.
Ren Fail. 1995 Sep;17(5):619-27. doi: 10.3109/08860229509037628.
Mucormycoses is a fungus which increasingly has been reported as a cause of opportunistic infection during the last 40 years. This infection is most commonly associated with underlying predisposing conditions, particularly diabetic ketoacidosis, hematologic and other malignancies, steroid therapy, broad-spectrum antibiotic therapy, or various acquired and hereditary immunodeficient disease states. The present report is that of a previously healthy patient with acute renal failure secondary to a postviral rhabdomyolysis syndrome, who received corticosteroids and developed unsuspected and undiagnosed systemic mucormycosis. Autopsy revealed that he died as a consequence of a massive pulmonary hemorrhage due to disseminated invasive mucormycosis, involving both the lungs and kidneys. A review of the literature reporting disseminated mucormycosis in association with renal failure is provided. Mucormycosis should be considered in immunocompromised patients with renal failure and fevers of unknown origin so that early diagnosis and prompt surgical and medical therapy may be instituted.
毛霉病是一种真菌,在过去40年中,作为机会性感染的病因,其报告越来越多。这种感染最常与潜在的易感因素相关,特别是糖尿病酮症酸中毒、血液系统及其他恶性肿瘤、类固醇治疗、广谱抗生素治疗或各种获得性和遗传性免疫缺陷疾病状态。本报告描述的是一名既往健康的患者,继发于病毒感染后横纹肌溶解综合征导致急性肾衰竭,接受了皮质类固醇治疗,并发生了未被怀疑和诊断的系统性毛霉病。尸检显示,他死于播散性侵袭性毛霉病引起的大量肺出血,累及肺和肾。本文提供了一篇关于与肾衰竭相关的播散性毛霉病的文献综述。对于肾衰竭且不明原因发热的免疫功能低下患者,应考虑毛霉病,以便尽早诊断并及时进行手术和药物治疗。