- 期刊
Rhinocerebral Mucormycosis in a Case of Malignant Lymphoma
鼻腦部頭狀菌感染於惡性淋巴瘤之ㄧ病例報告
摘要
頭狀菌是一種少見、急性、致命性的伺機感染。正常人很少因此黴菌而致病。頭狀菌通常發生在糖尿病、白血病、淋巴瘤、多發性骨髓瘤、癌症合併化學療法、器官移植合併免疫抑制劑療法、燒傷、尿毒症、使用抗生素或類固醇等病人。菌絲奇異的侵犯組織能力，特別喜歡侵犯血管，常直接穿透或沿血管生長，造成出血性栓塞和缺血性組織壞死。淋巴瘤患者接受化學療法後常引起全身散播性或肺部頭狀菌病，但鼻腦部頭狀菌感染則不多見。一位 54 歲罹患惡性淋巴瘤的病人，在接受化學療法後不久產生鼻塞及頭痛，症狀持續且加劇，接著，眼臉下垂，眼球凸出，結膜紅腫，並出現多對腦神經麻痺症狀。檢查鼻腔黏膜發現有黑色壞死焦痂，作 KOH 染色及組織切片檢查，證實有頭狀菌感染。這位病人因為早期的診斷及適當的治療，而成為少數幾位惡性淋巴瘤罹患鼻腦部頭狀菌感染而仍能存活的病例。
關鍵字
無資料並列摘要
Mucormycosis, an uncommon opportunistic fungal infection, usually occurs in im-munocompromised patients. It is rapidly progressive and almost always fatal. Patients with lymphoma are susceptible to pulmonary or disseminated mucormycosis, whereas rhinocerebral mucormycosis in such patients, as far as we know, is rarely reported. We present a patient with malignant lymphoma who exhibited such an acute rhinocerbral infection after chemotherapy which manifested initially as a stuffy nose and intractable headache. Then ptosis, proptosis, chemosis and multiple cranial nerve palsies appeared. Eschar was found in the nasal cavity. Direct KOH smear and tissue biopsy revealed mucormycotic infection. Infection. He survived because of early diagnosis and prompt treatment.
延伸閱讀
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