伪装的威胁:鼻眶毛霉菌病伪装成急性泪囊炎。

Sonali Vinay Kumar, Vikas Sharma, Manoj Gopal Madakshira, Vinay Kumar, Natasha Vinay Kumar, Alok Sati
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引用次数: 0

摘要

毛霉病是一种侵袭性的、危及生命的真菌感染,主要影响免疫功能低下的个体。它通常表现为鼻-眶或鼻-脑疾病。然而,罕见的是,其最初的表现可能非常类似于无害的状况,如急性泪囊炎,这容易导致更高的发病率。在此,我们报告一个52岁的糖尿病患者,他表现出急性泪囊炎的症状。开始使用广谱抗生素,但患者没有改善治疗。进一步的调查,包括影像学和活检,揭示了侵袭性毛霉病。立即开始手术清创和抗真菌治疗,但延迟诊断最终导致明显的眼眶受累。对于有糖尿病或免疫抑制等危险因素且伴有泪囊炎且对标准治疗无反应的毛霉菌病患者,应高度怀疑其临床表现。在这种情况下,早期诊断和积极干预在改善患者预后方面起着关键作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Disguised Threat: Rhino-Orbital Mucormycosis Masquerading as Acute Dacryocystitis.

Mucormycosis is an aggressive, life-threatening fungal infection predominantly affecting immunocompromised individuals. It typically manifests as rhino-orbital or rhino-cerebral disease. However, rarely, its initial presentation may closely resemble an innocuous condition like acute dacryocystitis, which is prone to result in higher morbidity rates. Herein, we report a case of a 52-year-old diabetic patient who presented with symptoms suggestive of acute dacryocystitis. Broad-spectrum antibiotics were started, but the patient did not improve with therapy. Further investigations, including imaging and biopsy, unraveled invasive mucormycosis. Prompt surgical debridement and antifungal therapy were initiated, but the delayed diagnosis culminated in significant orbital involvement. A high index of clinical suspicion is warranted for mucormycosis in patients with risk factors such as diabetes or immunosuppression who present with dacryocystitis and are unresponsive to standard treatment. Early diagnosis and aggressive intervention play a pivotal role in improving patient outcomes in this condition.

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