Primary cutaneous mucormycosis complicating the use of adhesive tape to secure the endotracheal tube
Primary cutaneous mucormycosis complicating the use of adhesive tape to secure the endotracheal tube
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DOI：
10.1007/bf03017426
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发表时间：
2002-10-01
期刊：
影响因子：
--
通讯作者：
Alsuwaida, K
中科院分区：
文献类型：
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作者：
Alsuwaida, K
目的：报道一例罕见的原发性皮肤毛霉病(PCM)，并用胶带固定气管插管。临床特征：一位39岁的系统性红斑狼疮(SLE)女性患者在固定气管插管的胶带下形成四个环形穿孔溃疡，中心坏死，边缘隆起，呈线性分布于左侧脸颊。组织活检发现在表皮和真皮中发现广泛的、分枝的、不分隔的菌丝，与毛霉菌病相一致，最好用银染证实。培养的根霉菌种呈阳性。静脉注射两性霉素B的治疗是成功的。结论：由于这种疾病的罕见和病原菌培养的困难，毛霉菌病的诊断往往是难以捉摸的。组织活检和直角分枝的无间隔菌丝镜检是唯一的诊断方法。免疫功能低下的患者应进行新的溃烂或斑块样病变的皮肤活检。早期诊断和及时治疗对于PCM的良好结果至关重要。
Purpose: To report a rare case of primary cutaneous mucormycosis (PCM), complicating securing of the endotracheal tube with adhesive tape.Clinical features: A 39-yr-old woman with systemic lupus erythematosus (SLE) developed four annular, punched out ulcers with a necrotic centre and elevated border in a linear distribution over the left cheek, under the tape securing the endotracheal tube. A tissue biopsy revealed broad, branching, nonseptate hyphae found in epidermis and dermis consistent with mucormycosis, best demonstrated with silver staining. Cultures were positive for Rhizopus species. Treatment with iv amphotericin B was successful.Conclusion: Because of the rarity of the disease and the difficulty of culturing the causative organism, diagnosis of mucormycosis is often elusive. Tissue biopsy and microscopic visualization of non-septate hyphae with right-angled branching are the only methods for making the diagnosis. Skin biopsy of new ulcerative or plaque-like lesions should be obtained in immunocompromised patients. Early diagnosis and prompt treatment are critical for favourable outcomes in PCM.