A case of invasive rhino-orbital-cerebral mucormycosis

doi:10.3877/cma.j.issn.1674-1358.2022.02.010

Abstract

Abstract:

Objective

To investigate the clinical features of invasive rhino-orbital-cerebral mucormycosis (ROCM) and to improve the understanding of this disease.

Methods

The clinical characteristics of one case with ROCM in Qingdao Municipal Hospital on October 26th, 2020 were analyzed, retrospectively.

Results

A 53 year-old-female patient with ROCM was admitted to our hospital, with head pain and left nasal and facial swelling. The CT scanning showed that the mucosa of left nasal sinus and bilateral ethmoid sinus were thickened with soft tissue shadow, and the bone of the medial wall of maxillary sinus was slightly blurred. The pathological specimen and blood examination showed that rhizopusoryzae was positive. Although, this case was given anti-infection treatment with imipenemcilastatin, vancomycin, voriconazole and amphotericin B systemically, but the condition got worse and died finally.

Conclusions

ROCM is with high clinical mortality, progress rapidly, for patients with suspected or confirmed mucormycosis, systematic antifungal treatment and surgical debridement should be carried out immediately and appropriately, which could improve the prognosis.

Key words: Mucormycosis, Sinusitis, Aggressive

Nan Wang, Yi Zhang, Ming An. A case of invasive rhino-orbital-cerebral mucormycosis[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2022, 16(02): 137-142.

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References 27

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日期（2020年）	白细胞计数（× 10⁹/L）	中性粒细胞计数（× 10⁹/L）	淋巴细胞百分率（%）	CRP（mg/L）
10月26日	18.65	15.63	11.5	19.09
10月27日	26.43	23.77	4.8	114.02
10月28日	20.48	18.31	3.5	296.98
10月29日	17.05	15.91	3.6	322.51
10月30日	21.54	20.51	2.1	251.09
10月31日	24.06	21.76	4.7	127.33
11月1日	18.42	16.49	6.1	284.21
11月2日	14.41	10.72	21	343.87
11月4日	9.06	7.20	15.7	297.78

日期（2020年）	白细胞计数（× 10⁹/L）	中性粒细胞计数（× 10⁹/L）	淋巴细胞百分率（%）	CRP（mg/L）
10月26日	18.65	15.63	11.5	19.09
10月27日	26.43	23.77	4.8	114.02
10月28日	20.48	18.31	3.5	296.98
10月29日	17.05	15.91	3.6	322.51
10月30日	21.54	20.51	2.1	251.09
10月31日	24.06	21.76	4.7	127.33
11月1日	18.42	16.49	6.1	284.21
11月2日	14.41	10.72	21	343.87
11月4日	9.06	7.20	15.7	297.78

日期（2020年）	K⁺（mmol/L）	Na⁺（mmol/L）	CI^-（mmol/L）	CO₂（mmHg）	GLU（mmol/L）
10月26日	4.20	129	90	6.9	23.93
10月27日	5.59	131	96	8.4	19.76
10月28日	3.68	139.27	105.70	18.9	11.65
11月02日	3.75	166	132	24.8	10.51
11月03日	6.98	167.17	131.04	27	16.38

日期（2020年）	K⁺（mmol/L）	Na⁺（mmol/L）	CI^-（mmol/L）	CO₂（mmHg）	GLU（mmol/L）
10月26日	4.20	129	90	6.9	23.93
10月27日	5.59	131	96	8.4	19.76
10月28日	3.68	139.27	105.70	18.9	11.65
11月02日	3.75	166	132	24.8	10.51
11月03日	6.98	167.17	131.04	27	16.38

日期（2020年）	治疗方案
10月26日	左氧氟沙星注射液、左奥硝唑氯化钠注射液、甲泼尼龙琥珀酸钠
10月27日14时	哌拉西林他唑巴坦+左奥硝唑
10月27日18时	亚胺培南西司他丁+万古霉素
10月28日	亚胺培南西司他丁+万古霉素+伏立康唑
10月30日~11月4日	亚胺培南西司他丁+万古霉素+伏立康唑+两性霉素B脂质体

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