巴西毛霉病管理工作队

IF 2.8 4区医学 Q2 INFECTIOUS DISEASES

Brazilian Journal of Infectious Diseases Pub Date : 2025-09-19 DOI:10.1016/j.bjid.2025.104579

Patrick Leon de Godoy Macedo , Mariane Taborda , Vítor Falcão de Oliveira , Adriana Satie Gonçalves Kono Magri , Lígia Lins Frutuoso , Gideane Mendes de Oliveira , Sinaida T. Martins , Daniel Wagner de Castro Lima Santos , Fabianne Altruda de Moraes Costa Carlesse , Francelise Bridi Cavassin , Kelsen Dantas Eulálio , Marcia Lazera Andréa , Andréa d’Avila Freitas , José Ernesto Vidal , Dayvison Francis Saraiva Freitas , Marcia Garnica , Terezinha do Menino Jesus Silva Leitão , Rosely Maria Zancopé-Oliveira , Marcia de Souza Carvalho Melhem , Flavio Queiroz Telles , Marcello Mihailenko Chaves Magri

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引用次数: 0

摘要

毛霉病是一种罕见但危及生命的真菌感染，在巴西的发病率有所上升，特别是在COVID - 19大流行期间。目的为巴西卫生保健系统中毛霉病的诊断和管理提供一个基于证据的、具体情况的指南。临床特征：以鼻眶型脑疾病为主，其次为肺部、皮肤、胃肠道和弥散性疾病；认知延迟会显著增加死亡率。全球毛霉病的发病率正在增加，特别是在糖尿病、血液恶性肿瘤、移植和皮质类固醇暴露的患者中。最常被分离的种是阿根霉，在种分布上可能存在区域差异。在巴西，全面的流行病学数据仍然很少。早期，建议积极的手术清创加两性霉素B脂质体诱导（5-10 mg/kg/天），随后使用异磺康唑或泊沙康唑；严格控制高血糖和免疫抑制是必要的。结论标准化的国家指导、改进的快速诊断、系统监测和公平的药物可及性对减轻巴西毛霉病负担至关重要。

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Brazilian task force for the management of mucormycosis

Background

Mucormycosis is a rare but life‑threatening fungal infection that has shown an increased incidence in Brazil, especially during the COVID‑19 pandemic.

Objective

To provide an evidence‑based, context‑specific guideline for the diagnosis and management of mucormycosis within the Brazilian healthcare system. Clinical features: Rhino‑orbito‑cerebral disease predominates, followed by pulmonary, cutaneous, gastrointestinal and disseminated forms; delayed recognition dramatically increases mortality.

Epidemiology

The global incidence of mucormycosis is increasing, particularly among patients with diabetes mellitus, hematologic malignancies, transplantation, and corticosteroid exposure. The most frequently isolated species is Rhizopus arrhizus, and regional variations in species distribution may be present. In Brazil, comprehensive epidemiological data remain scarce.

Treatment

Early, aggressive surgical debridement plus induction with liposomal amphotericin B (5–10 mg/kg/day) followed by isavuconazole or posaconazole is recommended; strict control of hyperglycemia and immunosuppression is essential.

Conclusion

Standardized national guidance, improved rapid diagnostics, systematic surveillance and equitable drug availability are critical to reduce Brazil’s mucormycosis burden.

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来源期刊

Brazilian Journal of Infectious Diseases 医学-传染病学

CiteScore

5.50

自引率

0.00%

发文量

925

审稿时长

41 days

期刊介绍： The Brazilian Journal of Infectious Diseases is the official publication of the Brazilian Society of Infectious Diseases (SBI). It aims to publish relevant articles in the broadest sense on all aspects of microbiology, infectious diseases and immune response to infectious agents. The BJID is a bimonthly publication and one of the most influential journals in its field in Brazil and Latin America with a high impact factor, since its inception it has garnered a growing share of the publishing market.