Harrill W C, Stewart M G, Lee A G, Cernoch P
Department of Otolarynology and Communicative Sciences, Baylor College of Medicine, Houston, TX 77030, USA.
Laryngoscope. 1996 Oct;106(10):1292-7. doi: 10.1097/00005537-199610000-00024.
Rhinocerebral mucormycosis is a well-described fulminant fungal infection that typically presents acutely in patients with diabetic ketoacidosis or immunosuppression. Chronic presentations of rhinocerebral mucormycosis have also been described. In the chronic infection, the disease course is indolent and slowly progressive, often occurring over weeks to months. The authors report 2 cases of chronic rhinocerebral mucormycosis (CRM) treated at their institution and review 16 other cases reported in the English-language literature. In these cases, the median time from symptom onset to diagnosis was 7 months. The most common presenting features of CRM are ophthalmologic and include ptosis, proptosis, visual loss, and ophthalmoplegia. CRM occurs predominantly in patients with diabetes and ketoacidosis. The incidence of internal carotid artery and cavernous sinus thrombosis is higher in CRM patients than in those with the acute disease, although the overall survival rate for CRM patients is 83%. CRM is clinically distinct from chronic Entomophthorales infection.
鼻脑型毛霉菌病是一种已被充分描述的暴发性真菌感染，通常在糖尿病酮症酸中毒或免疫抑制患者中急性发作。鼻脑型毛霉菌病的慢性表现也有相关报道。在慢性感染中，病程进展缓慢，通常持续数周或数月。本文作者报告了在他们机构治疗的2例慢性鼻脑型毛霉菌病（CRM）病例，并回顾了英文文献中报道的其他16例病例。在这些病例中，从症状出现到诊断的中位时间为7个月。CRM最常见的表现特征是眼部症状，包括上睑下垂、眼球突出、视力丧失和眼肌麻痹。CRM主要发生于糖尿病和酮症酸中毒患者。与急性鼻脑型毛霉菌病患者相比，CRM患者颈内动脉和海绵窦血栓形成的发生率更高，尽管CRM患者的总体生存率为83%。CRM在临床上与慢性虫霉感染不同。
