毛霉菌病:临床表现、诊断和治疗的最新进展。

IF 3.6 3区 医学 Q2 INFECTIOUS DISEASES Current Opinion in Infectious Diseases Pub Date : 2023-12-01 Epub Date: 2023-09-21 DOI:10.1097/QCO.0000000000000976
Natalie J M Dailey Garnes, Dimitrios P Kontoyiannis
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引用次数: 0

摘要

综述目的:毛霉菌病(MCR)是一种常见的机会性霉菌感染,最近世界卫生组织将毛霉菌列为优先病原体。自新冠肺炎大流行背景下MCR大爆发以来,人们对这种感染的兴趣显著上升,尤其是在印度。在此,我们总结了最近(最近24 月)发表了关于MCR临床方面的信息。最近的发现:该疾病的临床表现仍然多变,难以诊断,治疗也很困难。2021年,新冠肺炎期间,印度爆发了新冠肺炎相关毛霉菌病(CAM)病例,主要表现为中眼眶病或中脑疾病。其经典的危险因素包括新冠肺炎三联征、糖尿病失控和皮质类固醇的使用。尽管在MCR的及时诊断方面存在困难,但在血液中使用分子技术来帮助早期诊断方面已经取得了重大进展,这可以促进早期适当的治疗并改善结果。此外,在使用影像学对疾病进行分期、根据分期确定需要什么类型的多模式治疗以及基于组织的毛霉素识别方面也取得了进展。总结:尽管MCR的前景有所改善,但有效的新抗真菌药物、风险分层和最佳多模式方法仍然没有得到满足。
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Mucormycosis: update on clinical presentation, diagnosis, and treatment.

Purpose of review: Mucormycosis (MCR) is a common opportunistic mold infection, and Mucorales were recently designated by WHO as priority pathogens. The interest in this infection has risen significantly since the major outbreak of MCR in the context of the COVID-19 pandemic, particularly in India. Herein, we summarize recently (last 24 months) published information regarding clinical aspects of MCR.

Recent findings: The disease remains protean in its clinical presentation, difficult to diagnose, and challenging to treat. In 2021, cases of COVID-19-associated mucormycosis (CAM) exploded in India during COVID-19 and manifested primarily as sino-orbital or sino-cerebral disease. Its classic risk factors included the triad of COVID-19, uncontrolled diabetes mellitus and use of corticosteroids. Despite difficulties in the timely diagnosis of MCR, significant progress has been made with the use of molecular techniques in blood to assist with earlier diagnosis, which can facilitate earlier appropriate therapy and improve outcomes. In addition, advances have been made in the use of imaging to stage the disease, determining what types of multimodal therapy are required depending on staging, and tissue-based identification of Mucorales.

Summary: Although the outlook for MCR has improved, effective new antifungals, risk stratification, and the optimal multimodality approaches remain an unmet need.

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来源期刊
CiteScore
6.70
自引率
2.60%
发文量
121
审稿时长
6-12 weeks
期刊介绍: This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on two topics, every issue of Current Opinion in Infectious Disease delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as HIV infection and AIDS; skin and soft tissue infections; respiratory infections; paediatric and neonatal infections; gastrointestinal infections; tropical and travel-associated diseases; and antimicrobial agents.
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