目标:犀牛流脑毛霉菌病(ROCM),一种罕见的血管侵袭性真菌感染,已经成为印度第二波冠状病毒病(COVID-19)大流行期间的一次重大疫情,报告了超过28,000例病例。这项研究的目的是描述ROCM的成像光谱,这可能有助于及时诊断,考虑到其在免疫抑制患者高负荷人群中的严重预后(例如,COVID-19,艾滋病毒-艾滋病,等。).
方法:对有可疑颅面毛霉菌病症状的患者的临床资料和影像学进行评估。使用计算机断层扫描(CT)或磁共振(MR)成像进行诊断。活检,和文化。采用描述性统计方法进行数据分析。
结果:样本组包括36名患者,年龄从33岁到75岁,其中男性31人(86.11%),女性5人(13.8%)。共有30例(83.33%)患者与COVID-19感染呈正相关,29例(80.55%)患者与糖尿病呈正相关。主要表现为面部疼痛和肿胀(20例;55.55%)。14例(38.88%)患者出现颅内扩散。我们的研究显示死亡率为38.88%(14例患者)。
结论:ROCM,曾经被认为主要发生在糖尿病患者中,越来越多地出现在其他免疫抑制患者身上,比如COVID-19。CT和MR成像有助于结合病理和微生物学相关性提供早期诊断。需要在开始两性霉素B治疗的同时立即纠正免疫抑制,并对患病组织进行广泛而勤奋的手术清创。
OBJECTIVE: Rhino-orbito-cerebral mucormycosis (ROCM), a rare angio-invasive fungal infection, had become a major outbreak during the second wave of the coronavirus disease (COVID-19) pandemic in India, with over 28,000 reported cases. The purpose of this study was to describe the imaging spectrum of ROCM, which may prove useful in prompt diagnosis, considering its grave prognosis in populations with a high load of immunosuppressed patients (e.g., COVID-19, HIV-AIDS, etc.).
METHODS: Evaluation of the clinical data and imaging of patients with symptoms suspicious of mucormycosis of the craniofacial region was done. The diagnosis was made using computed tomography (CT) or magnetic resonance (MR) imaging, a biopsy, and culture. The data analysis was done using descriptive statistical methods.
RESULTS: The sample group consisted of a total of 36 patients ranging from 33 years to 75 years of age, out of which 31 (86.11%) were male and five (13.8%) were female. A total of 30 (83.33%) patients had a positive correlation with COVID-19 infection, and 29 (80.55%) patients had a positive correlation with diabetes. The major presenting complaints were facial pain and swelling (20 patients; 55.55%). The intracranial spread was seen in 14 (38.88%) patients. Our study demonstrated a mortality rate of 38.88% (14 patients).
CONCLUSIONS: ROCM, once considered to occur predominantly in diabetics, is increasingly being seen in other immunosuppressive patients, such as COVID-19. CT and MR imaging help provide an early diagnosis in conjunction with pathologic and microbiological correlations. Immediate correction of immunosuppression with the initiation of amphotericin B therapy combined with extensive and diligent surgical debridement of the diseased tissue is required.