作为 COVID-19 冠状病毒感染并发症的粘液瘤病:眼部症状

A. Babushkin, L. I. Gilemzianova, I. P. Ponomarev
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摘要

COVID-19 会导致免疫抑制,增加继发感染的风险,包括真菌病,如粘孢子菌病(MM),因此医生应注意 COVID-19 患者发生 MM 的可能性。由于没有特殊的主诉或临床症状,而且这种疾病很少见,尤其是在气候温和的发达国家,因此在初次检查时往往无法诊断出 MM。因此,病原体(子囊菌丝体)的检测在诊断中起着关键作用。超过 70% 的 MM 患者的眼睛会受到损害。根据文献记载,最常见的表现是眼睑下垂、眼肌麻痹、眼球外翻、注射和结膜化脓。患者通常会出现眼痛、眼眶蜂窝织炎或眼眶痰,并伴有视力下降。为了有效治疗这种严重的感染性 COVID-19 并发症(表现为深部和侵袭性霉菌病),必须采取跨学科的方法。综合治疗应使用抗真菌药物和对症疗法,主要是通过手术切除受影响的坏死组织,使感染灶恢复正常。预后总是非常严重。
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Mucormycosis as a complication of COVID-19 coronavirus infection: eye symptoms
COVID-19 causes an immunosuppressive condition and increases the risk of secondary infections, including fungal diseases such as mucormycosis (MM), so doctors should be aware of the possibility of MM development in COVID-19 patients. Since no specific complaints or clinical symptoms exist and the disease is rare, especially in developed countries with a moderate climate, it is often impossible to diagnose MM at the initial examination. Therefore, the detection of the pathogen (mycelium zygomycetes) plays a key role in the diagnosis. Over 70 % of MM patients experience eye damages. According to the literature, the most common manifestations thereof are blepharoptosis, ophthalmoplegia, exophthalmos, injection and conjunctival chemosis. Quite often, the patients have eye pains, orbital cellulitis or phlegmon of the orbit, accompanied by a decrease in vision. For the effective treatment of this severe infectious COVID-19 complication, which takes the form of deep and aggressive mycosis, an interdisciplinary approach is necessary. The complex treatment should make use of antimycotic agents and symptomatic therapy, and, essentially, surgical rehabilitation of infection foci by removing the affected necrotic tissues. The prognosis is always very serious.
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