鼻-眼-脑型毛霉菌病的研究现状

Advance study of rhinocerebralmucormycosis

毛霉菌病是由毛霉菌目真菌引起的急性感染性疾病,进展迅速且致命。最常见的类型为鼻-眼-脑型毛霉菌病,其早期症状类似于鼻窦炎、眶蜂窝织炎等,此时临床误诊率较高;此病进展迅速,真菌扩散至眼内引起眼内炎、巩膜穿孔,患者视力骤降至无光感,甚至丧失眼球;最终真菌累及神经系统而危及生命。毛霉菌病常见于糖尿病血糖控制不佳、酮症酸中毒及免疫抑制的患者。本文就鼻-眼-脑型毛霉菌病的诱发因素、感染途径、发病机制、临床表现特征及诊断治疗要点的最新研究进展进行综述,旨在提高临床对本病的诊断及治疗水平。

Mucormycosis is a rare, rapidly progressive life threatening opportunistic fungal infection, with rhinocerebral mucormycosis being the most common type. Rhinocerebral mucormycosis usually presents symptoms similar to sinusitis and orbital cellulitis during its early stage,which often leads to a misdiagnosis at the very beginning,and progresses rapidly to endophthalmitis,blindness,sclera perforation, eyeball atrophy, and even gets the central nervous system involved, thus leading to death. Mucormycosis is particularly common in patients with poor glycemic control, ketoacidosis and immunosuppression. The purpose of this review is to highlight the predisposing factors, infection pathway, pathogenesis, clinical presentations, diagnosis, and management of rhinocerebral mucormycosis, hence further promote the early diagnosis and immediate treatment of the disease.