[Fatal case of rhinocerebral mucormycosis on the background of type II diabetes mellitus].

Q4 Medicine Arkhiv patologii Pub Date : 2024-01-01 DOI:10.17116/patol20248603152
A V Smirnov, V V Ermilov, A N Sasin, N V Grigor'eva, A E Poplavskiy, O A Chernetsky, S V Blokhina, V S Grableva, O N Barkanova, D Yu Gurov, I V Ermilova, A A Poplavskaya
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Abstract

Mucormycosis is a disease caused by fungi of the Mucorales family, widespread in the environment, with pronounced angiotropism and the ability to angioinvasion, leading to thrombosis with surrounding necrosis. The main triggers for the development of mucormycosis are: immunodeficiency states, use of glucocorticosteroid drugs, decompensation of diabetes mellitus, concomitant diseases, age > 65 years. We present a clinical case of rhinocerebral mucormycosis in a 79-year-old patient against the background of uncontrolled type 2 diabetes mellitus with ketoacidosis, a condition after previous glucocorticosteroid therapy for COVID-19 (according to the severity of the disease). After suffering a new coronavirus infection caused by the SARS-CoV-2 virus, she was admitted to the hospital with complaints characteristic of mucormycosis. On the 5th day of hospital stay, the patient's condition worsened significantly, despite the correction of the therapy, and on the 12th day the patient died. According to the results of the autopsy, it was established that the rhinocerebral mucormycosis was complicated by thrombosis of the anterior and posterior left cerebral arteries with subsequent infarctions in the frontal lobe and parieto-occipital region of the brain left hemisphere, cerebral edema, which was the immediate cause of death.

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[Ⅱ型糖尿病背景下的犀脑粘液瘤病死亡病例]。
粘孢子菌病是一种由粘孢子菌科真菌引起的疾病,广泛存在于环境中,具有明显的血管扩张性和血管侵袭能力,导致血栓形成和周围坏死。粘孢子菌病的主要诱因是:免疫缺陷状态、使用糖皮质激素药物、糖尿病失代偿期、并发疾病、年龄大于 65 岁。我们报告了一个 79 岁患者的鼻脑粘液瘤病临床病例,该患者患有未控制的 2 型糖尿病并伴有酮症酸中毒,这是之前糖皮质激素治疗 COVID-19(根据疾病的严重程度)后出现的情况。在受到由 SARS-CoV-2 病毒引起的新型冠状病毒感染后,她因具有粘液瘤病特征的主诉入院。住院第 5 天,尽管进行了纠正治疗,但患者的病情仍明显恶化,第 12 天,患者死亡。根据尸检结果,确定鼻脑粘液瘤病并发左侧大脑前后动脉血栓形成,随后大脑左半球额叶和顶枕区梗死,脑水肿,这是死亡的直接原因。
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来源期刊
Arkhiv patologii
Arkhiv patologii Medicine-Pathology and Forensic Medicine
CiteScore
0.90
自引率
0.00%
发文量
55
期刊介绍: The journal deals with original investigations on pressing problems of general pathology and pathologic anatomy, newest research methods, major issues of the theory and practice as well as problems of experimental, comparative and geographic pathology. To inform readers latest achievements of Russian and foreign medicine the journal regularly publishes editorial and survey articles, reviews of the most interesting Russian and foreign books on pathologic anatomy, new data on modern methods of investigation (histochemistry, electron microscopy, autoradiography, etc.), about problems of teaching, articles on the history of pathological anatomy development both in Russia and abroad.
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