侵袭性鼻-眼-脑型毛霉菌病一例  

A case of invasive rhino-orbital-cerebral mucormycosis

作　　者：王楠[1] 张怡 安明[1] Wang Nan;Zhang Yi;An Ming(Department of Ophthalmology,Qingdao Municipal Hospital,Qingdao 266071,China)

机构地区：[1]青岛市市立医院眼科,青岛市266071

出　　处：《中华实验和临床感染病杂志（电子版）》2022年第2期137-142,共6页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的探讨侵袭性鼻-眼-脑型毛霉菌病(ROCM)的临床特点,以提高对该病的认知。方法回顾性收集2020年10月26日于青岛市市立医院确诊的1例ROCM患者的临床资料,并分析该病的临床特点。结果1例侵袭性鼻-眼-脑型毛霉菌病的53岁女性患者,因头痛伴左侧鼻面部肿胀于至本院住院治疗,鼻窦CT提示左侧鼻窦、双侧筛窦黏膜增厚,有软组织影,上颌窦内侧壁骨质稍模糊。组织病理及血液送检结果提示米根霉菌阳性。虽然联合给予亚胺培南西司他丁、万古霉素、伏立康唑及两性霉素B抗感染治疗,但患者最终病情恶化,经抢救无效死亡。结论侵袭性鼻-眼-脑型毛霉菌病病情进展迅速,病死率高,对怀疑或者确诊的毛霉菌病患者,应立即进行系统性抗真菌治疗,并择机进行外科清创,可改善患者预后。Objective To investigate the clinical features of invasive rhino-orbital-cerebral mucormycosis(ROCM)and to improve the understanding of this disease.Methods The clinical characteristics of one case with ROCM in Qingdao Municipal Hospital on October 26th,2020 were analyzed,retrospectively.Results A 53 year-old-female patient with ROCM was admitted to our hospital,with head pain and left nasal and facial swelling.The CT scanning showed that the mucosa of left nasal sinus and bilateral ethmoid sinus were thickened with soft tissue shadow,and the bone of the medial wall of maxillary sinus was slightly blurred.The pathological specimen and blood examination showed that rhizopusoryzae was positive.Although,this case was given anti-infection treatment with imipenemcilastatin,vancomycin,voriconazole and amphotericin B systemically,but the condition got worse and died finally.Conclusions ROCM is with high clinical mortality,progress rapidly,for patients with suspected or confirmed mucormycosis,systematic antifungal treatment and surgical debridement should be carried out immediately and appropriately,which could improve the prognosis.

关 键 词：毛霉菌病 鼻窦炎 侵袭性 

分 类 号：R519[医药卫生—内科学]