Pediatric pulmonary mucormycosis in a diabetic patient treated with extended pleurectomy and Clagett procedure.
Pediatric pulmonary mucormycosis in a diabetic patient treated with extended pleurectomy and Clagett procedure.
复制标题
接受扩大胸膜切除术和 Clagett 手术治疗的糖尿病患者的小儿肺毛霉菌病。
DOI：
10.1016/j.epsc.2019.101210
复制
发表时间：
2019
影响因子：
0.4
通讯作者：
Velotta,JeffreyB
中科院分区：
文献类型：
--
作者：
Gologorsky,RebeccaC;Ely,Sora;Rothenberg,KaraA;Glaser,Carol;Velotta,JeffreyB
毛霉是一种在健康人群中普遍存在的非致病性真菌。在免疫功能低下的宿主中，无功能或缺失的中性粒细胞和巨噬细胞导致真菌侵袭和感染[1]。侵袭性黏液（黏液霉菌病）最常累及鼻窦、脑或肺。肺毛霉菌病通常出现在有器官移植或血液恶性肿瘤病史的患者中，在单独患有糖尿病的患者中很少见。儿童肺毛霉菌病的流行病学和管理描述甚少。我们报告一个罕见的这种疾病的发生，并发节段性肺动脉血栓在一个15岁与控制不良的糖尿病。他严重的耐药感染最终通过抗真菌药物和积极的手术清创成功治疗。肺动脉节段性血栓在未经抗凝治疗的基础感染治疗后消退。
Mucor is a ubiquitous fungus that is non-pathogenic in healthy people. In immunocompromised hosts, nonfunctional or absent neutrophils and macrophages result in fungal invasion and infection [1]. Invasive mucor (mucormycosis) most commonly involves the sinuses, brain, or lungs. Pulmonary mucormycosis typically presents in patients with a history of organ transplantation or hematologic malignancy [2], and is rare in patients with diabetes alone. The epidemiology and management of pediatric pulmonary mucormycosis is poorly described. We report an unusual occurrence of this disease, complicated by segmental pulmonary artery thrombus in a 15-year-old with poorly controlled diabetes. His severe, medication-resistant infection was ultimately treated successfully with antifungal medication combined with aggressive surgical debridement. The pulmonary artery segmental thrombus resolved after treatment of the underlying infection without anticoagulation.