Rhinocerebral Mucormycosis-A Case Report and Literature Review

白黴菌病是一種由白黴菌目所造成的急性致命的黴菌感染。在大多數的情況下，它是一種少見的伺機性感染，具有百分之十五至三十四的高死亡率^7。高危險群包括了血糖控制不良的糖尿病患、血液腫瘤病患、因器官或骨髓移植而接受免疫抑制藥物的病患、及因鐵質過高而接受defetoxamine治療的病患等。鼻顱腔感染是白黴菌病中最常見的一種，適當的治療包括早期診斷、將易受感染的因素排除、積極的清瘡手術、及以amphotericin B進行全身性的抗黴菌治療。我們在此報告-51歲女性過去有控制不良的糖尿病、腎臟功能衰竭、及鐵質過多正接受deferoxamine治療，她於左臉頰發現一膿瘍，並有左眼球突出及泛紅，病理切片證實為少見的白黴菌感染。在高劑量的amphotericin B治療及手術清創下，病患仍死於敗血症。本文將回顧鼻顱腔白黴菌病診斷及治療之文獻。

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並列摘要

Mucormycosis is an acute fatal infection caused by a fungus of the order Mucorales. It is a rare disease and almost always an opportunistic infection with a high mortality ranging from 15% to 34%^7. The high risk groups include patients with uncontrolled diabetics, hematologic malignancy, organ or bone marrow transplantation under immunosuppressant therapy, or iron overload under defetoxamine treatment. Rhinocerebral mucormycosis is the most common form of the disease. Appropriate management includes rapid diagnosis, reversal of underlying predisposing factors, aggressive surgical debridement, and systemic antifungal infection with amphotericin B. We report a case of 51 year-old woman with multiple underlying disease including poorly-controlled diabetes mellitus, end-stage renal disease, and iron overload under deferoxamine. The initial presentation included purulent cheek nodule and proptosis of left side with chemosis. Biopsy confirmed the diagnosis of the rare fungal infection, mucormycosis. She died for progressive sepsis even under high dose Amphotericin B and surgical debridement. The literature of rhinocerebral mucormycosis are reviewed.

並列關鍵字

rhinocerebral mucormycosis ； zygomycosis ； fungal infection

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Rhinocerebral Mucormycosis-A Case Report and Literature Review

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