糖尿病酮症酸中毒并发鼻眶部毛真菌等混合菌感染(附1例报告并文献复习)  

DIABETIC KETOACIDOSIS COMPLICATED WITH RHINO-ORBIT MUCORMYCOSIS: REPORT OF ONE CASE AND REVIEW OF LITERATURE

作　　者：郑军[1] 陈颖[1] 王芳[1] 于江苏[1] 袁鹰[1] 

机构地区：[1]青岛大学医学院附属医院内分泌科,山东青岛266003

出　　处：《青岛大学医学院学报》2012年第3期276-278,共3页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的了解糖尿病酮症酸中毒并发鼻眶部毛真菌等混合菌感染的临床表现和诊疗方法,提高对毛真菌的认识和早期诊断及治疗水平。方法对1例糖尿病酮症酸中毒并发鼻眶部毛真菌等混合菌感染病人的临床资料进行分析,并复习国内外相关文献。结果病人为男性,35岁,糖尿病酮症酸中毒,根据脓液镜检、坏死组织病理切片及血培养结果,临床确诊为鼻眶部毛真菌并发产气肠杆菌、表皮葡萄球菌感染。该病人应用两性霉素B及哌拉西林钠-他唑巴坦钠、替考拉宁治疗大约4周后,病情得以控制。结论脓液镜检和组织病理切片有助于毛真菌病的早期诊断,静脉应用两性霉素B并配合局部两性霉素B冲洗、早期手术彻底清除病灶、去除真菌的生长环境、治疗原发病可延缓毛真菌病的进展。Objective To understand the clinical manifestations and management of diabetic ketoacidosis （DK） complicated with rhino-orbit mucormycosis （ROM）, and raise the level of early diagnosis and treatment of this disease. Methods The clinical information of one DK patient comlicated with ROM was analyzed, and literature concerned reviewed. Results The DK patient was a 35-year-old man. A diagnosis of ROM complicationg infection of enterobaeter aerogenes and staphylococcus epidermidis was made based on microscopy / of pus, pathological examination of necrotic tissue, and blood culture. The condition was controlled after about four-week treatment with amphotericin B, piperaeillin sodium/tazohactam sodium and Teicoplanin. Conclusion Microscopic examination of pus and pathologican section is conducive to an early diagnosis of mucormycosis. Intravenous amphotericin B combined with local irrigation of this drug, early removal of the focus of infection, and the habitat of fungi, and treatment of primary disease may delay the progression of mucormycosis.

关 键 词：糖尿病酮症酸中毒 毛霉菌病 眼眶 鼻 两性霉素B 

分 类 号：R587.2[医药卫生—内分泌]