耳毛霉病:综合文献综述。

Ahmad Alkheder, Adel Azar, Ghina Sukkar, Abdulmajeed Yousfan
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摘要

耳毛霉菌病是一种罕见的侵袭性真菌感染,主要影响免疫功能低下的个体,特别是糖尿病控制不佳的患者。本文报告一例54岁女性糖尿病患者,并发孤立性耳廓毛霉菌病和面神经麻痹。患者出现右耳水肿、坏死和剧烈疼痛,进展超过10天,无外伤史。最初的治疗包括广谱抗生素和静脉注射两性霉素B脂质体,随后进行手术清创和部分耳廓切除术。尽管广泛的软组织受累,影像学显示没有骨侵蚀或明显压迫面神经。面部神经功能在38天内由House-Brackmann分级IV级逐渐改善至II级。经过连续的手术干预和长期的抗真菌治疗,患者的病情稳定下来,最终在第61天恢复。综合文献综述确定了6例耳廓毛霉菌病的记录病例,均涉及糖尿病患者,死亡率为33.3%。面神经麻痹4例,感染消退后仍持续存在。该病例强调了早期诊断、积极抗真菌治疗、手术清创和对潜在疾病细致管理的重要性,以优化耳毛霉菌病的预后,耳毛霉菌病是一种具有重大诊断和治疗挑战的疾病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Auricular Mucormycosis: Comprehensive Literature Review.

Auricular mucormycosis is an exceptionally rare and aggressive fungal infection primarily affecting immunocompromised individuals, particularly those with poorly controlled diabetes. This report presents the case of a 54-year-old diabetic woman with isolated auricular mucormycosis and facial nerve palsy. The patient developed right auricular edema, necrosis, and severe pain, progressing over 10 days, with no history of trauma. Initial management included broad-spectrum antibiotics and intravenous liposomal amphotericin B, followed by surgical debridement and partial auricular resection. Despite extensive soft tissue involvement, imaging revealed no bony erosion or significant compression of the facial nerve. Facial nerve function gradually improved from House-Brackmann grade IV to grade II within 38 days. The patient's condition stabilized after sequential surgical interventions and prolonged antifungal therapy, culminating in recovery by day 61. A comprehensive literature review identified 6 documented cases of auricular mucormycosis, all involving diabetic patients, with a mortality rate of 33.3%. Facial nerve paralysis, observed in 4 cases, often persisted despite infection resolution. This case underscores the importance of early diagnosis, aggressive antifungal therapy, surgical debridement, and meticulous management of underlying conditions to optimize outcomes in auricular mucormycosis, a condition with significant diagnostic and therapeutic challenges.

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