新型冠状病毒感染后膝关节毛霉菌病伴病理性骨折1例

Sergiu-Andrei Iordache, A. Cursaru, B. Șerban, M. Popa
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引用次数: 1

摘要

摘要毛霉病是一种真菌感染,一般发生在有一定程度免疫抑制的患者中,如恶性肿瘤患者、糖尿病患者、HIV感染患者或需要使用免疫抑制药物的患者。最终的诊断是通过收集感染过程中的一些组织并使用实验室培养分离真菌来确定的。毛霉病的治疗是复杂的,包括尽量减少危险因素,严格的手术清创和特异性抗真菌治疗。我们报告一例54岁男性患者,他有SARS-COV2感染背景(中等形式),在来我院就诊前3个月开始感染,最初在家中治疗。患者在布加勒斯特大学急诊医院骨科就诊,因左膝疼痛和功能性阳痿,这是在就诊前约2个月发生的创伤所致,当时症状逐渐恶化。临床和影像学检查确定病理性左股骨髁间上骨折的诊断。本病例报告的目的是介绍由于COVID-19诱导的免疫抑制或使用对抗炎症过程所需的免疫抑制剂治疗而导致的机会性病原体感染的风险。患者表现为中度COVID-19,在家中接受非甾体抗炎药和抗生素治疗,以防止细菌重复感染。无论医生的医学专业如何,在诊断和治疗方面,毛霉病仍然是一个具有挑战性的情况。在这种情况下,COVID-19是导致毛霉病出现的危险因素之一。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A rare case of knee joint mucormycosis with pathological fracture after COVID-19 infection
Abstract Mucormycosis is a fungal infection that generally occurs in patients with some degree of immunosuppression, such as patients with malignancies, diabetes, HIV infection, or patients who require the administration of immunosuppressive drugs. The final diagnosis is established by collecting some tissue from the infectious process and isolating the fungus using lab cultures. The treatment of mucormycosis is complex and consists of trying to reduce risk factors, rigorous surgical debridement, and specific antifungal treatment. We present the case of a 54-year-old male patient with a background of SARS-COV2 infection (moderate form), that started 3 months prior to presentation to our hospital, initially treated at home. The patient presented to the Orthopaedics Department of the University Emergency Hospital of Bucharest with pain and total functional impotence in his left knee as a result of a trauma that occurred about 2 months before the presentation to the hospital, at that moment with progressive worsening of the symptoms. Clinical and imaging examination established the diagnosis of pathological supra-intercondylar fracture of the left femur. The purpose of this case report is to present the risk of infection with an opportunistic agent as a result of immunosuppression induced by COVID-19 or its treatment with immunosuppressive agents necessary to combat the inflammatory process. The patient presented with a moderate form of COVID-19 treated at home with nonsteroidal anti-inflammatory drugs and antibiotics to prevent a bacterial superinfection. Mucormycosis remained a challenging situation for the physician, regardless of his medical specialty, both in terms of diagnosis and treatment. In this case, COVID-19 is one of the risk factors that contributed to the appearance of mucormycosis.
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