面鼻眶脑毛霉病1例并文献复习

A case report of rhino-orbitocerebral mucormycosis

目的 总结1例面鼻眶脑毛霉病(ROCM)的诊疗经验,提高对该疾病的认识。方法 回顾性分析1例ROCM患者的临床病例资料,结合相关文献进行讨论总结。结果 本例患者以口腔牙齿酸痛为首发表现,既往糖尿病血糖控制差,完善相关检查,实验室确诊为根霉菌属感染的ROCM病,经控制基础疾病、抗真菌、手术治疗等,患者最终临床结局死亡。结论 ROCM病多见于未控制的糖尿病患者,临床表现多样,典型表现为局部皮肤或黏膜焦痂样坏死,影像学检查无特异性表现,病理及真菌培养为其诊断金标准。早期诊断,及早有效的抗真菌、基础疾病治疗、手术治疗是诊治关键。

Objective This study aimed summarize the diagnosis and treatment experience in the case of rhino-orbitocerebral mucormycosis(ROCM)and improve the understanding of the disease. Methods The clinical case data of a patient with ROCM were retrospectively reviewed and summarized in combination with relevant literature. Results This patient’s first manifestation was oral dental soreness,with poor glycemic control previous diabetes. The relevant examinations were improved,and the diagnosis of ROCM due to Rhizopus infection was confirmed by the laboratory. After controlling the underlying disease,antifungal and surgical operations,the patient final clinical outcome was death. Conclusion ROCM mostly is seen in patients with uncontrolled diabetes.Its clinical presentation is diverse,and typically involves localized cutaneous or mucosal eschar necrosis. There was no specific manifestation in the imaging examination. Pathology and fungal culture were the gold standard for diagnosis. Early diagnosis and effective treatment,such as antifungal therapy,basic disease treatment,and surgical treatment are the key to diagnosis and treatment.