Covid-19相关毛霉菌病研究综述

Harshada I. Patil, Dhiraj Kamble
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引用次数: 2

摘要

毛霉病或接合菌病被定义为由毛霉属和接合菌属成员引起的隐匿性真菌病。毛霉病是一种罕见但严重的侵袭性真菌感染。人体小体的感染以外耳、指甲、皮肤的浅表形式发生,而肺部、胃肠道和大脑类型的内脏形式则表现出来。毛霉病与暴露于高水平的空气真菌污染有关。在2019冠状病毒病的背景下,印度的事件越来越多。大多数记录在案的病例与COVID-19患者不适当使用皮质类固醇有关。糖尿病(73.5%)、恶性肿瘤(9.0%)和器官移植是印度人毛霉病的主要危险因素(7.7%)。在糖尿病患者中,毛霉病发展为一种具有破坏性和潜在致命性的疾病。糖尿病酮症酸中毒加速真菌侵袭。危险因素包括未控制的糖尿病,特别是酮症酸中毒,类固醇使用,年龄,中性粒细胞减少。毛霉病的诊断需要仔细检查临床表现,磁共振成像方式,早期使用计算机断层扫描(CT)。毛霉菌病可损害鼻、鼻窦、眼眶、中枢神经系统、肺、胃肠道、皮肤、颌骨、骨骼、关节、心脏、肾脏和纵隔。新一代抗真菌治疗,如两性霉素B、酮康唑、伊曲康唑和伏立康唑。两性霉素B有几种剂型,包括脂质体和脂质两性霉素,两性霉素的胶体扩散用于大多数常见的真菌感染。突破性的侵袭性真菌感染,当引入新的唑类药物,泊沙康唑和异唑康唑时,尽管它们具有抗粘膜活性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Brief Review on Covid-19 associated Mucormycosis
Mucormycosis or Zygomycosis is defined as an insidious mycosis by members of the Mucorales and zygomycotic species. Mucormycosis is rare but severe invasive fungal infection. Infection with human corpuscles occurs in superficial form in the outer ear, nails, skin and visceral forms manifest in lung, gastrointestinal, and cerebral types. Mucormycosis is associated with exposure to high levels of airborne fungal contamination. In the context of COVID-19, India has seen an increasing number of incidents. The majority of the cases documented are related to the inappropriate use of corticosteroids in COVID-19 patients. Diabetes mellitus (73.5%), ma-lignancy (9.0%), and organ transplantation are among the main risk factors for mucormycosis in Indians (7.7 percent). In diabetic patients, Mucormycosis develops as a destructive and potentially fatal condition. Diabetic ketoacidosis accelerates fungal invasion. Risk factors include uncontrolled diabetes mellitus, especially ketoacidosis, steroid use, age, neutropenia Mucormycosis diagnosis involves a careful examination of clinical manifestations, magnetic resonance imaging modalities, early use of computed tomography (CT). Mucormycosis can impair the nose, sinuses, orbit, CNS, pulmonary, gastro-intestinal tract (GIT), skin, jaws bones, joints, heart, kidney, and mediastinum. Newer generation antifungal treatments such as amphotericin B, ketoconazole, itraconazole, and voriconazole. There are several formulations of amphotericin B available, including liposomal and lipid-based amphotericin, the colloidal diffusion of amphotericin for most common fungal infections. Breakthrough invasive fungal infections persist when new azoles, posaconazole, and isavuconazole are introduced, despite their anti-mucoral activity.
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