急诊科新冠肺炎后鼻眼眶毛霉菌病

IF 0.1 Q4 EMERGENCY MEDICINE Journal of Emergency Medicine Case Reports Pub Date : 2022-03-10 DOI:10.33706/jemcr.1072718
B. Çelik, Halit Karakisa, M. Emem, B. Karaca
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引用次数: 1

摘要

鼻眼眶毛霉菌病(ROM)是一种急性暴发性感染。2019冠状病毒病(新冠肺炎)后发展的ROM病例数量正在增加。一名62岁的男性患者住进了叙利亚北部的急诊科,他抱怨新发的视力下降、肿胀和左眼严重肿胀。值得注意的是,泼尼松250mg疗程为3天,用于治疗新冠肺炎。我们发现他有糖尿病(DM)病史10年。体格检查显示左眼上睑下垂、眼球突出和眼球运动受限。所有其他系统检查均正常。住院后进行的颅骨和眼眶磁共振成像扫描显示,左侧眼眶的蝶窦、筛窦和额窦壁密度增加。尽管进行了抗真菌和手术治疗,患者还是在第14天死亡。在治疗中使用类固醇和伴有糖尿病是主要的诱发因素。这种疾病的死亡率和发病率很高,在卫生保健不足的地理区域,其预后受到不利影响。
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Rhino-orbital mucormycosis after COVID-19 in the emergency department
Rhino-orbital mucormycosis (ROM) is an acute and fulminant infection. The number of ROM cases developing after coronavirus disease 2019 (COVID-19) is increasing. A 62-year-old male patient was admitted to the emergency department in northern Syria complaining of new-onset vision loss, swelling, and severe swelling of the left eye. It was noted that a 3-day course of prednisolone 250 mg was given to treat COVID-19. We found that he had a history of diabetes mellitus (DM) for 10 years. Physical examination revealed ptosis, proptosis, and ocular movement restriction in all directions in the left eye. All other systemic examinations were normal. A cranial and orbital magnetic resonance imaging scan performed after hospitalization for further evaluation and treatment showed an increase in the density of the sphenoid, ethmoid, and frontal sinus walls in the left orbit. Despite antifungal and surgical treatment, the patient died on day 14. The use of steroids in treatment and the presence of concomitant DM are the main predisposing factors. The prognosis of this disease, which has a high mortality and morbidity, is adversely affected in geographic regions where health care is inadequate.
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