2型糖尿病合并孤立性气管毛霉病两例报道并文献复习

Type 2 Diabetes Mellitus Complicated with Solitary Tracheal Mucormycosis:Two Cases Report and Literature Review

毛霉病是一种罕见且致命的疾病。本文报道2例2型糖尿病合并孤立性气管毛霉病患者的诊疗经过,患者表现为呼吸困难,胸部CT检查提示气管软组织增生伴管腔狭窄,经支气管镜获取病变组织并行病理检查证实为毛霉病。行硬质支气管镜治疗及全身抗真菌治疗后患者病情好转,随访期间病情稳定。孤立性气管毛霉病因缺乏特异性影像学及临床表现,易造成漏诊及误诊,从而延误治疗。病理检查对毛霉病的早期诊断必不可少,且确诊后行内镜介入治疗联合全身抗真菌治疗可改善患者预后。

Mucormycosis is a rare and fatal disease.This paper reports the diagnosis and treatment of 2 patients with type 2 diabetes mellitus complicated with solitary tracheal mucormycosis.The patients presented with dyspnea.Chest CT scan revealed hyperplasia of tracheal soft tissue with luminal stenosis.Pathological examination of the diseased tissue obtained by bronchoscopy confirmed that it was mucormycosis.Patients were treated with rigid bronchoscopy and systemic antifungal therapy for improvement,and their condition was stable during follow-up.The solitary tracheal mucormycosis lacks specific imaging and clinical manifestations,which can easily lead to missed diagnosis and misdiagnosis and delay treatment.Pathological examination is essential for the early diagnosis of mucormycosis,and endoscopic intervention combined with systemic antifungal therapy after diagnosis can improve the prognosis of patients.