山东大学耳鼻喉眼学报 ›› 2022, Vol. 36 ›› Issue (6): 96-100.doi: 10.6040/j.issn.1673-3770.0.2021.582

• 论著 • 上一篇    

面鼻眶脑毛霉病1例并文献复习

宋华荣1,唐光华2,朱任良3   

  1. 1.广州中医药大学 第二临床医学院, 广东 广州 510405;
    2.广东省中医院 急诊科, 广东 广州 510120;
    3.广东省中医院 耳鼻咽喉头颈科, 广东 广州 510120
  • 发布日期:2022-12-07
  • 通讯作者: 朱任良. E-mail:entzrl@126.com

A case report of rhino-orbitocerebral mucormycosis

SONG Huarong1, TANG Guanghua2, ZHU Renliang3   

  1. 1. The Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, Guangdong, China;
    2. Department of Emergency, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510120, Guangdong, China;
    3. Department of Otorhinolaryngology & Head and Neck Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510120, Guangdong, China
  • Published:2022-12-07

摘要: 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。

关键词: 毛霉病, 鼻脑型毛霉病, 根霉菌, 糖尿病, 牙齿酸痛

Abstract: 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.

Key words: Mucormycosis, Rhino-orbitocerebral mucormycosis, Rhizopus, Diabetes, Toothache

中图分类号: 

  • R762
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