Mucormycosis: A sweet enemy, case series

Santiago Manrique-Castaño, Luis Armando Velásquez-Trujillo, Mariana Ángel Correa, José Humberto Bravo, Lorena Matta Cortes
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Abstract

Mucormycosis is a rare fungal infection caused by fungi of the Mucorales order that occurs in immunocompromised individuals or with loss of skin or mucosa barrier integrity. This report presents four cases of rhinocerebral mucormycosis attended at a third-level hospital in Cali (Colombia) during a period of three years. All patients had different case histories and times of evolution. All four had a previous or de novo diagnosis of type 2 diabetes mellitus, with glycated hemoglobin higher than 10% on admission. We ruled out other possible pathologies that could explain their immunocompromised condition. Mucormycosis diagnosis was made with direct visualization of hyaline coenocytic hyphae on biopsies. The basis of treatment was liposomal amphotericin B and surgical debridement. Two patients presented bacterial coinfection. One asked for voluntary discharge without having completed the treatment, and another one died. The remaining two have attended controls and had an adequate evolution.

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粘孢子菌病:甜蜜的敌人,病例系列。
粘孢子菌病是一种罕见的真菌感染,由粘孢子菌目真菌引起,好发于免疫力低下或皮肤或粘膜屏障完整性丧失的人群。我们报告了哥伦比亚卡利市一家三甲医院在三年内接诊的四例鼻脑粘孢子菌病病例。四名患者的临床表现和病情发展时间各不相同。所有患者都被诊断出患有 2 型糖尿病,包括新发糖尿病和既往糖尿病,入院时糖化血红蛋白均超过 10%,而且都排除了可能导致免疫力下降的其他疾病。黏菌病是通过直接观察活组织中的透明合胞(合胞)菌丝而确诊的。治疗的主要方法是脂质体两性霉素 B 和手术清创。两名患者合并有细菌感染。四名患者中,一名未完成治疗自愿退出,一名死亡。其余两名患者接受了随访,病情发展良好。
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