鼻上颌真菌骨髓炎的合并症和死亡率:一项回顾性研究。

IF 1 4区 医学 Q3 SURGERY
Lt Gen Dr Nk Sahoo, Apoorva Mowar, Snigdha Singh, Himani Vaswani
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引用次数: 0

摘要

真菌感染主要影响免疫功能低下的个体,其免疫系统缺乏减轻真菌的能力。在大多数情况下,除非及时进行手术和抗真菌治疗,否则病情会迅速恶化,导致死亡。本回顾性研究旨在了解鼻上颌复合体感染中真菌霉菌的发生率和类型,以及与之相关的合并症和死亡率。方法:本回顾性研究于2022年1月至2023年12月在一家三级医疗转诊中心进行,经机构伦理委员会批准。本研究纳入了经组织病理学证实的鼻上颌复合体真菌感染的所有年龄组男女患者。结果:共23例,其中男16例,女7例。4人死亡,19人痊愈。4例死亡患者中,2例行上颌全切除术联合眶外清除术,1例行半上颌切除联合鼻窦清创术,1例行上颌全切除术。合并糖尿病(DM) 14例,糖尿病合并高血压(HTN) 3例,慢性肾病(CKD)合并糖尿病和HTN 6例。讨论:在我们的研究中,我们观察到所有23例真菌感染患者都有相关的合并症。4例死亡中有多种合并症。因此,可以推断鼻上颌真菌感染患者多伴有合并症。结论:真菌感染与DM、HTN、CKD等合并症相关。这加强了这样一个事实,即在医学上受损的患者中,与曲霉或念珠菌等其他真菌元素相比,毛霉病传播更快,导致广泛的组织累及,死亡率更高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comorbidity and Mortality Associated With Rhinomaxillary Fungal Osteomyelitis: A Retrospective Study.

Introduction: Fungal infections mostly affect immunocompromised individuals whose immune system lacks the ability to mitigate the fungi. In most cases, unless surgery and antifungal therapy are administered promptly, the condition deteriorates rapidly leading to death. The present retrospective study aims to find out the incidence and type of fungal moulds in the infection affecting the nasomaxillary complex and correlate its comorbidity and mortality associated with it.

Methods: This retrospective study was conducted in a tertiary care referral center from January 2022 to December 2023 after obtaining necessary approval from the institutional ethical committee. Patients from both the sex in all age group with histopathologically proven fungal infection of nasomaxillary complex were included in the study.

Results: Total there were 23 cases of which 16 were males and 7 were females. There were 4 deaths and 19 patients recovered from the disease. Of the 4 deaths, 2 patients were treated with total maxillectomy with orbital exenteration, 1 patient treated with hemimaxillectomy with debridement of sinuses and 1 with total maxillectomy. The associated comorbidities were diabetes mellitus (DM) in 14 cases, DM with hypertension (HTN) in 3 cases and chronic kidney disease (CKD) with DM and HTN in 6 cases.

Discussion: In our study it was observed that all the 23 patients with fungal infections had associated comorbidities. Multiple comorbidities were observed in 4 cases of death. So, an inference can be made that the patients with rhinomaxillary fungal infections are mostly associated with comorbidities.

Conclusion: In all the cases, fungal infection was associated with comorbidities namely DM, HTN, and CKD. This strengthens the fact that in medically compromised patients, mucormycosis spreads faster, causes extensive tissue involvement, and higher fatality as compared with other fungal elements like Aspergillus or Candidal species.

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来源期刊
CiteScore
1.70
自引率
11.10%
发文量
968
审稿时长
1.5 months
期刊介绍: ​The Journal of Craniofacial Surgery serves as a forum of communication for all those involved in craniofacial surgery, maxillofacial surgery and pediatric plastic surgery. Coverage ranges from practical aspects of craniofacial surgery to the basic science that underlies surgical practice. The journal publishes original articles, scientific reviews, editorials and invited commentary, abstracts and selected articles from international journals, and occasional international bibliographies in craniofacial surgery.
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