Mucorales

Mucorales
  • 文章类型: Journal Article
    在COVID-19大流行期间,COVID-19患者的毛霉菌病病例显着增加,尤其是在印度,但不是唯一的。所呈现的病例突出了毛霉菌病的异质性,强调认识诱发因素的重要性,如免疫抑制,由于合并症或药物。由于非特异性临床表现,诊断毛霉菌病构成了挑战,需要多学科的方法来准确诊断。治疗涉及多管齐下的方法,围绕早期开始抗真菌治疗以及手术干预和基础疾病的管理,重点是控制免疫抑制。了解COVID-19与毛霉菌病易感因素之间的关系是制定预防和治疗策略的基础。
    During the COVID-19 pandemic, a significant increase in cases of mucormycosis was observed in COVID-19 patients, especially in India, but not exclusively. The presented cases highlight the heterogeneous nature of mucormycosis, emphasizing the importance of recognizing predisposing factors, such as immunosuppression, due to comorbidities or medication. Diagnosing mucormycosis poses a challenge due to nonspecific clinical manifestations, requiring a multidisciplinary approach for accurate diagnosis. Treatment involves a multi-pronged approach centered around the early initiation of antifungal therapy alongside surgical intervention and the management of underlying conditions, with an emphasis on controlling immunosuppression. Understanding the relationship between COVID-19 and predisposing factors for mucormycosis is fundamental for developing prevention and treatment strategies.
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  • 文章类型: Case Reports
    毛霉菌病,一种罕见但危及生命的真菌感染,在临床管理中提出了重大挑战,特别是在未控制的糖尿病患者中。此病例报告介绍了一名44岁妇女的临床历程,该妇女在国内刀伤后发展为快速发展的Mucorales感染。她的病情,并发糖尿病酮症酸中毒和白色念珠菌共感染,导致严重的手部痰和败血症。尽管进行了积极的干预,感染继续发展,最终导致病人的死亡。
    Mucormycosis, a rare but life-threatening fungal infection, poses significant challenges in clinical management, particularly in patients with uncontrolled diabetes mellitus. This case report presents the clinical journey of a 44-year-old woman who developed a rapidly progressing Mucorales infection following a domestic knife injury. Her condition, complicated by diabetic ketoacidosis and co-infection with Candida albicans, led to severe hand phlegm and sepsis. Despite aggressive intervention, the infection continued to advance, ultimately resulting in the patient\'s demise.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    一只8岁的Pygora母鹿被赠送给加州大学戴维斯分校,兽医教学医院由于2周的面部肿胀不愈合。尽管接受了治疗,但病变仍在增长,导致咀嚼不适,右鼻通道几乎没有气流,导致了安乐死.粗略检查,发现了一个大的面部肿块,有通过皮肤和硬腭的引流道。在截面上,质量是棕色粉红色的,同质,而且易碎.在肺和肾脏中发现了脓肿样肿块。面部的组织病理学,包括口腔和鼻腔,唾液腺,和淋巴结,以及肺部和肾脏的病变,显示大面积坏死,有许多宽带状,大部分是无菌的,真菌菌丝与合子菌一致。对福尔马林固定的真菌生物进行PCR,面部石蜡包埋的组织确定了Mucorales和曲霉属的Lichtheimiacorymbifera(以前称为Absidiacorymbifera)。怀疑病变是由于真菌鼻炎或牙科饲料嵌塞而开始的,随后扩散到面部并全身扩散到肺和肾脏。我们在这里描述了与山羊面部毛霉菌病相关的病变,并提供了兽医物种中的紫草菌感染和山羊中的真菌感染的文献综述。
    An 8-y-old Pygora doe was presented to the University of California-Davis, Veterinary Medical Teaching Hospital because of non-healing facial swelling of 2-wk duration. The lesion grew despite medical treatment, causing discomfort masticating, little-to-no airflow from the right nasal passage, and led to euthanasia. On gross examination, a large facial mass with a draining tract through the skin and hard palate was identified. On section, the mass was brown-pink, homogeneous, and friable. Abscess-like masses were identified in the lungs and kidney. Histopathology of the face, including oral and nasal cavities, salivary glands, and lymph nodes, as well as the lung and kidney lesions, revealed large areas of necrosis with numerous wide ribbon-like, mostly aseptate, fungal hyphae consistent with zygomycetes. PCR for fungal organisms performed on formalin-fixed, paraffin-embedded tissue from the face identified Lichtheimia corymbifera (formerly Absidia corymbifera) of the order Mucorales and an Aspergillus sp. The lesion was suspected to have started either as a fungal rhinitis or dental feed impaction, subsequently spreading to the face and systemically to the lungs and kidney. We describe here the lesions associated with facial mucormycosis in a goat and present a literature review of L. corymbifera infection in veterinary species and fungal infections in goats.
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  • 文章类型: Journal Article
    毛霉菌病是一种新出现的疾病,主要影响免疫功能低下的患者;然而,在有免疫能力的个体中也有报道。儿科人群的研究有限,主要以案例研究或系列报道。本病例报告的目的是介绍起源于苏门答腊岛的小儿毛霉菌病,印度尼西亚。一名十三岁男童因面部坏死累及鼻部,被转介至三甲医院,口服,和左上颌区域,以及左眶周围水肿。没有记录已知的潜在条件。广泛的组织病理学发现证实了诊断,pauci-septate,在90°分枝的带状菌丝。患者由由耳朵组成的多学科小组管理,鼻子,喉咙,传染病,皮肤病学,手术,微生物学,和病理科。患者的管理包括坏死病变的清创和抗生素和抗真菌药(氟康唑)。由于不可用,患者未接受两性霉素B治疗。患者入院30天后死亡。这个案例突出了保持高度怀疑侵袭性毛霉菌病的重要性,即使在有免疫能力的儿童中,当出现症状和体征时,尤其是在资源有限的环境中。
    Mucormycosis is an emerging disease that primarily affects immunocompromised patients; however, it has also been reported in immunocompetent individuals. Studies in the pediatric population are limited and reported mostly in case studies or series. The aim of this case report is to present a pediatric mucormycosis originated from Sumatra Island, Indonesia. A 13-year-old boy was referred to a tertiary hospital with facial necrosis involving the nasal, oral, and left maxillary areas, as well as left periorbital edema. No known underlying conditions were documented. The diagnosis was confirmed by histopathological findings of broad, pauci-septate, ribbon-like hyphae branching at 90°. The patient was managed by a multidisciplinary team consisting of the ear, nose, and throat, infectious diseases, dermatology, surgery, microbiology, and pathology departments. Management of the patient included debridement of the necrotic lesion and antibiotics and anti-fungal (fluconazole). Due to unavailability, the patient was not treated with amphotericin B. The patient died after 30 days of admission. This case highlights the importance of maintaining a high suspicion of invasive mucormycosis, even in immunocompetent children, when symptoms and signs are present, especially in resource-limited settings.
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  • 文章类型: Case Reports
    上肢毛霉菌病是一种罕见的,威胁生命的真菌感染主要影响免疫功能低下的患者。我们报告了一例30岁的急性骨髓性白血病妇女,她在住院期间出现了这种感染。罪魁祸首是Mucorales,以快速进化而闻名的孢子菌属亚组,高度致命的感染。她发烧了,发冷,尽管最初使用了广谱抗生素,但她的左前臂上的病变恶化了。穿刺活检证实了诊断,导致抗真菌治疗与伊沙康唑硫酸盐和后来的两性霉素B,结合手术。及时干预至关重要,因为延迟治疗会导致严重的并发症和死亡。早期的怀疑,组织学,显微镜,真菌培养对准确诊断至关重要。治疗主要涉及两性霉素B,而诸如两性霉素B和高压氧等辅助疗法显示出希望。此案强调了迅速采取医疗和手术行动的重要性,增强免疫功能低下患者毛霉菌病的早期检测。
    Upper-extremity mucormycosis is a rare, life-threatening fungal infection mainly affecting immunocompromised patients. We report a case of a 30-year-old woman with acute myelogenous leukemia who developed this infection during her hospital stay. The culprit was Mucorales, a subgroup of Zygomycetes species known for fast-progressing, highly lethal infections. She presented with fever, chills, and a lesion on her left forearm that worsened despite initial broad-spectrum antibiotics. A punch biopsy confirmed the diagnosis, leading to antifungal therapy with isavuconazonium sulfate and later amphotericin B, combined with surgery. Timely intervention is critical because delayed treatment can result in severe complications and death. Early suspicion, histology, microscopy, and fungal cultures are vital for accurate diagnosis. Treatment primarily involves amphotericin B, whereas adjunctive therapies such as topical amphotericin B and hyperbaric oxygen show promise. This case underscores the importance of prompt medical and surgical action, enhancing early detection of mucormycosis in immunocompromised patients.
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  • 文章类型: Review
    我们报告了法国一名57岁的免疫功能正常的患者中罕见的主动脉双i假体同种异体毛霉菌病病例。手术和脂质体两性霉素B和伊沙武康唑双重抗真菌治疗后,结果良好。在文献综述中,我们确定了另外12例人工血管或心脏瓣膜毛霉菌病;死亡率为38%.
    We report a rare case of aorto-bi-iliac prosthetic allograft mucormycosis in a 57-year-old immunocompetent patient in France. Outcome was favorable after surgery and dual antifungal therapy with liposomal amphotericin B and isavuconazole. In a literature review, we identified 12 other cases of prosthetic vascular or heart valve mucormycosis; mortality rate was 38%.
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  • 文章类型: Case Reports
    背景:据报道,犀牛-流-脑毛霉菌病是控制不佳的糖尿病免疫受损患者的冠状病毒病后遗症。大多数病例是在印度发现的,其他地方只有19人报道。
    方法:我们在此报告临床结果,成像,微生物,以及在患有严重的SARS-CoV-2疾病与新发失代偿性糖尿病相关后,由Finegoldiamagna和Mucorales霉菌感染的具有免疫能力的67岁男性的组织病理学研究。
    结果:微生物学和组织学研究证实了Mucorales霉菌和Finegoldiamagna的存在,用抗生素和特定的抗真菌剂(泊沙康唑)成功治疗。
    结论:对严重SARS-CoV-2病患者进行仔细的多学科随访,对于及时诊断未控制的糖尿病和机会性感染等并发症是必要的。
    Rhino-orbito-cerebral mucormycosis has been reported as a sequela after coronavirus disease in immunocompromised patients with poorly controlled diabetes mellitus. Most cases have been identified in India, with only 19 reported elsewhere.
    We herein report the results of clinical, imaging, microbiological, and histopathological studies in an immunocompetent 67-year-old male with rhino-orbital infection by Finegoldia magna and Mucorales molds following severe SARS-CoV-2 disease associated with new-onset decompensated diabetes mellitus.
    Microbiological and histological studies confirmed the presence of both Mucorales molds and Finegoldia magna, which was successfully treated with antibiotics and a specific anti-fungal agent (Posaconazole).
    Careful multidisciplinary follow-up of patients treated for severe SARS-CoV-2 disease is necessary for the timely diagnosis of complications such as uncontrolled diabetes mellitus and opportunistic infections.
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  • 文章类型: Case Reports
    毛霉菌病是由毛霉菌引起的罕见机会性真菌感染,并伴有高死亡率。Rhino-orbito-cra全部的定位通常发生在患有不受控制的糖尿病的个体中。我们报道了一个41岁男性的病例,患有以前未诊断的糖尿病,表现为单侧面部广泛的黑色焦痂和糖尿病酮症酸中毒的迹象。脑磁共振成像显示左全鼻窦炎,左侧颅面水肿浸润,和左突起。在化脓前的早期发现了左侧内部颞脓肿。磁共振血管造影显示左侧颅内颈内动脉完全闭塞。鼻粘膜活检的组织病理学研究提示毛霉菌病。根据临床表现以及放射学和组织病理学发现,推测为犀牛或大脑毛霉菌病。鼻腔的培养,眼,和皮肤病变标本生长的根佐霉。并确认了诊断。该患者接受了全身性脂质体两性霉素B治疗。他死于多器官功能衰竭,然后才能进行手术清创,因为他处于危急状态,需要在手术治疗前稳定。
    Mucormycosis is a rare opportunistic fungal infection caused by Mucorales and associated with high mortality rates. Rhino-orbito-cerebral localization usually occurs in individuals with uncontrolled diabetes mellitus. We report the case of a 41-year-old male, with previously undiagnosed diabetes, who presented with unilateral facial extensive black eschar and signs of diabetic ketoacidosis. Cerebral magnetic resonance imaging showed left pansinusitis, left craniofacial edematous infiltrate, and left proptosis. A left internal temporal abscess was identified at an early pre-suppurative stage. Magnetic resonance angiography revealed total occlusion of the left intracranial internal carotid artery. A histopathological study of nasal mucosa biopsy suggested mucormycosis. According to the clinical presentation and the radiological and histopathological findings, rhino-orbito-cerebral mucormycosis was presumed. Culture of nasal, ocular, and skin lesion specimens grew Rhizomucor sp. and confirmed the diagnosis. The patient was treated with systemic liposomal amphotericin B. He died of multiple organ failure before surgical debridement was possible as he was in critical condition requiring stabilization before surgical treatment.
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  • 文章类型: Case Reports
    编码GATA2转录因子的基因中的种系致病变体(PV)可导致单核细胞的大幅减少,树突状细胞,自然杀伤细胞和B细胞。GATA2PV与骨髓性恶性肿瘤的风险增加以及对非结核性分枝杆菌和人乳头瘤病毒感染的易感性相关。此外,侵袭性真菌感染(IFIs)已在GATA2PV患者中报告,即使没有骨髓性恶性肿瘤。在这份报告中,我们介绍了一个40岁的男性Emberger综合征(GATA2突变,最近诊断为急性髓性白血病[AML]和淋巴水肿伴听力损失的病史),在接受其第一个疗程的缓解诱导化疗时发展为Mucorales鼻窦炎。此外,我们回顾了所有已发表的GATA2PV患者经证实的IFIs病例的文献.临床医生应该意识到GATA2PV患者可能容易受到机会性IFIs的影响,即使没有AML和抗肿瘤治疗。此外,我们的患者在AML诱导化疗的第一个疗程中明显不寻常地发生了毛霉菌病,这表明接受AML诱导化疗的种系GATA2PV患者可能由于侵袭性而处于早期发生IFIs的高风险,机会主义模具。
    Germline pathogenic variants (PVs) in the gene encoding the GATA2 transcription factor can result in profound reductions of monocytes, dendritic cells, natural killer cells and B cells. GATA2 PVs are associated with an increased risk of myeloid malignancies and a predisposition to nontuberculous mycobacterial and human papillomavirus infections. Additionally, invasive fungal infections (IFIs) have been reported in individuals with GATA2 PVs, even in the absence of myeloid malignancies. In this report, we present the case of a 40-year-old man with Emberger syndrome (GATA2 mutation, recently diagnosed acute myeloid leukaemia [AML] and history of lymphedema with hearing loss) who developed Mucorales sinusitis while receiving his first course of remission induction chemotherapy. Additionally, we review the literature on all published cases of proven IFIs in patients with GATA2 PVs. Clinicians should be aware that patients with GATA2 PVs could be vulnerable to opportunistic IFIs, even in the absence of AML and antineoplastic therapy. Furthermore, the distinctly unusual occurrence of mucormycosis during the first course of induction chemotherapy for AML in our patient indicates that patients with germline GATA2 PVs receiving induction chemotherapy for AML might be at high risk for early onset of IFIs due to aggressive, opportunistic moulds.
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