少根根霉引起皮肤型毛霉病12例临床分析

中国真菌学杂志　 2019, Vol. 14 　Issue (1): 20-23.

少根根霉引起皮肤型毛霉病12例临床分析

刘加, 梁官钊, 杨佳, 葛力瑜, 董嘉琤, 刘维达

中国医学科学院北京协和医学院皮肤病研究所中国医学真菌菌种保藏管理中心, 南京 210042

收稿日期:2018-05-11 出版日期:2019-02-28 发布日期:2019-02-28
通讯作者: 刘维达,E-mail:liumyco@hotmail.com E-mail:liumyco@hotmail.com
作者简介:刘加,女,博士研究生在读.E-mail:liuzhengxiang67@163.com
基金资助:
国家自然科学基金（81471905）

Clinical analysis of 12 cases with cutaneous mucormycosis caused by Rhizopus arrhizus

LIU Jia, LIANG Guan-zhao, YANG Jia, GE Li-yu, DONG Jia-cheng, LIU Wei-da

Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Management Center for the preservation of medical fungi in China, Nanjing, 210042, China

Received:2018-05-11 Online:2019-02-28 Published:2019-02-28

摘要/Abstract

摘要：

目的总结并分析自1991年以来我国报道少根根霉所致皮肤型毛霉病的临床资料，探讨其临床表现、易感因素、治疗策略及预后。方法通过文献检索中国发表的少根根霉感染病例，所有纳入文献均需有明确的诊断依据。结果获得12例少根根霉致皮肤感染患者的临床信息，平均年龄为46.83岁，男女比为5：1，未控制的糖尿病为最常见的基础疾病，而外伤往往为最常见诱因，临床主要表现为进行性、扩展性糜烂、溃疡、黑痂，诊断主要依靠真菌培养及组织病理学检查，两性霉素B联合局部清创为最常用的治疗方法，患者结局3例死亡，2例截肢，7例好转。结论少根根霉是毛霉病最常见致病菌之一。早期诊断进而针对性地治疗对挽救患者生命，改善预后具有重要意义。

关键词: 毛霉病, 皮肤型, 少根根霉, 临床分析

Abstract:

Objective To analyze clinical features of cutaneous mucormycosis caused by Rhizopus arrhizus since 1991 in China, and to further explore the typical clinical manifestation, predisposing factors, treatment strategies and prognosis. Methods Cases infected with rhizopus arrhizus reported in various data bases of China were searched thoroughly, clear diagnostic evidence should be described. Results Twelve cases were included in this paper. There were 10 males and 2 females separately, the average age of those patients was 46.83 years old. Uncontrolled diabetes mellitus was the most common risk factor and traumatic history could always be found in most cases. Aggressive erosion and ulcer were the most common clinical manifestations, and black eschar could be served as a clue to diagnosis. Combination amphotericin B with topical debridement was the most common treatment. Of all the patients, 3 of them resulted in death, 9 patients received favorable results of antifungal agents, but 2 cases underwent amputation surgery pitifully. Conclusions Rhizopus arrhizus was one of the most common pathogens causing mucormycosis, which might lead to death and deformity. Early diagnose and individual treatment are of great importance in saving lives and improving life qualities.

Key words: mucormycosis, cutaneous, Rhizopus arrhizus, clinical analysis

中图分类号:

R519
R756.6

刘加, 梁官钊, 杨佳, 葛力瑜, 董嘉琤, 刘维达. 少根根霉引起皮肤型毛霉病12例临床分析[J]. 中国真菌学杂志, 2019, 14(1): 20-23.

LIU Jia, LIANG Guan-zhao, YANG Jia, GE Li-yu, DONG Jia-cheng, LIU Wei-da. Clinical analysis of 12 cases with cutaneous mucormycosis caused by Rhizopus arrhizus[J]. Chinese Journal of Mycology, 2019, 14(1): 20-23.

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