PDF(Pubmed)
Abstract：
Mucormycosis is an invasive fungal infection that can cause acute clinical decompensation and death. The literature demonstrates case fatality rates around 50% with differential clinical courses contingent upon anatomical incursion. Rhino-orbital cerebral mucormycosis represents a rapidly hostile variant with poorer outcomes, warranting prompt recognition, workup, and intervention. It is seldom included in differential diagnoses in those with head and neck pathology within the inpatient setting as diagnostic parsimony and low prevalence lead this entity to be often overlooked. Given the acuity and risk factors involved, considering mucormycosis may be prudent during the assessment of hyperglycemic or immunodeficient patients exhibiting maxillofacial disease. When acquiring histories of presenting illness and performing physical examinations, assessment includes mindfulness of diabetes mellitus, craniofacial lesions, and alertness to clinical deterioration. Given the rising incidence of complicated diabetes mellitus in conjunction with a paucity of mucormycosis reports noting the orbit as the diagnostic harbinger, we report the case of a 59-year-old woman admitted to the critical care setting for diabetic ketoacidosis and altered mental status. Physical examination revealed a swollen orbit, later diagnosed as mucormycosis with associated sino-orbit involvement and cranial nerve deficits warranting urgent and extensive facial debridement.
摘要：
毛霉菌病是一种侵袭性真菌感染，可引起急性临床失代偿和死亡。文献表明，病死率约为50％，不同的临床过程取决于解剖侵入。犀眶脑毛霉菌病代表了一种快速敌对的变种，结果较差，保证得到及时的认可，workup,和干预。在住院患者中，头颈部病变患者的鉴别诊断很少包括在鉴别诊断中，因为诊断简约和低患病率导致该实体经常被忽视。鉴于所涉及的敏锐度和风险因素，在评估表现为颌面部疾病的高血糖或免疫缺陷患者时，考虑毛霉菌病可能是谨慎的。在获得患病和进行身体检查的历史时，评估包括糖尿病的正念，颅面病变,以及对临床恶化的警觉性。鉴于复杂性糖尿病的发病率上升以及毛霉菌病的缺乏，报告指出眼眶是诊断的先兆，我们报道了一例59岁女性因糖尿病酮症酸中毒和精神状态改变而入院重症监护.体格检查发现眼眶肿胀,后来被诊断为毛霉菌病并伴有鼻孔-眼眶受累和颅神经缺陷，需要紧急和广泛的面部清创。
