Improved Diagnosis and Prognosis of Mucormyucosis: A CLINICOPATHOLOGIC STUDY OF 33 CASES
Improved Diagnosis and Prognosis of Mucormyucosis: A CLINICOPATHOLOGIC STUDY OF 33 CASES
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改善毛霉菌病的诊断和预后：33例临床病理研究
作者：
N. Parfrey
毛霉菌病是一种罕见且常常致命的真菌感染，很少发生在其他健康人群中 (15, 18, 92)。几乎总是存在潜在的疾病，通常是糖尿病。它典型地出现在不同的解剖部位：鼻旁、鼻眶、鼻脑、大脑、肺部和胃肠道区域；以及四肢的软组织。它也可能表现为播散性疾病。毛霉菌病菌丝侵入组织必须通过显微镜观察才能确诊，但需要进行培养来鉴定所涉及的真菌种类。一项针对一家医院 50 年来 33 例病例的研究表明，这种感染的发病率正在增加。结果有了显着改善，同时也发生了从尸检到尸前诊断的重大转变。尸前诊断为稳定代谢、手术切除和适合该疾病的两性霉素 B 治疗提供了机会。
Mucormycosis is an uncommon, frequently fatal, fungal infection which rarely arises in otherwise healthy people (15, 18, 92). An underlying disease, frequently diabetes mellitus, is almost always present. It appears stereotypically in different anatomic sites: paranasal, rhinoorbital, rhinocerebral, cerebral, pulmonary, and gastrointestinal areas; and in the soft tissue of the extremities. It can also appear as disseminated disease. Tissue invasion by the hyphae of mucormycosis must be seen microscopically to establish the diagnosis, but culture is required to identify the fungal species involved. A study of 33 cases seen in one hospital over five decades suggests that the incidence of this infection is increasing. There has been a dramatic improvement in outcome, which has been paralleled by a major shift from postmortem to premortem diagnosis. Premortem diagnosis gives the opportunity for metabolic stabilization, surgical excision, and amphotericin-B therapy appropriate to this disease.