中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2010, Vol. 32 ›› Issue (4): 461-464.doi: 10.3881/j.issn.1000-503X.2010.04.022

• 论著 • 上一篇    下一篇

毛霉菌病的临床特征

吴迪1,张立民2,蒋颖2   

  1. 中国医学科学院北京协和医学院北京协和医院1内科2风湿免疫科,北京 100730
  • 收稿日期:2010-01-15 出版日期:2010-08-30 发布日期:2010-09-10
  • 通讯作者: 蒋颖 E-mail:jy_rheu_pumch@sina.com
  • 作者简介:010-65295001,电子邮件:jy_rheu_pumch@sina.com

Clinical Features of Mucormycosis

WU Di1,ZHANG Li-min2,JIANG Ying2   

  1. 1Department of Internal Medicine, 2Department of Rheumatology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China
  • Received:2010-01-15 Online:2010-08-30 Published:2010-09-10
  • Contact: JIANG Ying E-mail:jy_rheu_pumch@sina.com

摘要: 目的分析毛霉菌病的临床特征。方法回顾性分析北京协和医院1986至2009年收治的9例毛霉菌病患者的临床特征。结果患者平均年龄(31±19)岁[诊断前病程1周~31个月[鼻脑型1例、肺型4例、播散型2例、皮肤型1例、单纯中枢型1例[危险因素包括长期大量使用糖皮质激素、糖尿病、酸中毒、大面积皮肤破损等[辅助检查示血沉、C反应蛋白明显升高,6例存在免疫功能低下[肺部受累患者CT 表现为双肺多发片影[均使用静脉两性霉素B治疗,2例联合手术[住院期间1例播散型患者死亡,鼻脑型患者病情稳定,余患者均好转。结论毛霉菌病罕见,患者均存在高危因素,病情多进展迅速,应尽快诊断,正确治疗,以改善预后。

关键词: 毛霉菌病, 鞍鼻, 两性霉素B

Abstract: Objective To summarize the clinical features of patients with mucormycosis. MethodWe retrospectively analyzed the clinical data of all 9 cases of mucormycosis in our hospital from 1986 to 2009. ResultsThe average age was(31±19)years. The intervals between the onset of disease to diagnosis ranged from 1weeks to 31 months. One patient had rhinocerebral mucormycosis, 4 had pulmonary mucormycosis, 2 had disseminated mucormycosis, and 1 had isolated central nervous system mucormycosis. Risk factors included long-term high-dose usage of corticosteroids, diabetes, acidosis, and extensive skin lesions. Laboratory analysis showed elevated erythrocyte sedimentation rate and increased C-reactive protein. Laboratory evidences also suggested 6 patients were obviously immunocompromised. Chest CT scans of all patients with pulmonary mucormycosis revealed bilateral multiple patches. All patients were treated with intravenous amphotericin B, and two patients also underwent surgeries. One of two patients with disseminated mucormycosis died, the patient with rhinocerebral mucormycosis was stabilized, and the other patients were improved. ConclusionsMucormycosis is a rare disease, and all patients are immunocompromised. Due to the rapid progression and poor prognosis, early diagnosis and correct treatment are necessary and may improve survival.

Key words: mucormycosis, saddle nose, amphotericin B

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