小孢子根霉肺脓毒症1例报告及文献复习

U. K, G. R, Sadagopan Kumar
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摘要

与机会性真菌感染、毛霉病相关的高死亡率正在稳步上升。肺毛霉菌病虽然罕见,但多发于糖尿病和其他免疫抑制疾病患者。本文报道一例由小孢子根霉引起的肺毛霉病。本文收集了一位47岁男性肺结核合并自发性左侧气胸及糖尿病患者的痰液样本。采用表型和基因型方法对阳性真菌培养进行鉴定,并检测分离物对唑类和两性霉素b的抗真菌敏感性。根据ITS的表型特征和分子测序,鉴定病原为小孢子孢子菌。该分离物对所有抗真菌药物均敏感,患者对两性霉素B反应良好,严格控制血糖并联合抗感染治疗。虽然肺毛霉病是相对罕见的;它与肺结核和曲霉病有共同的临床表现,因此对易感高危患者的毛霉病临床怀疑是有必要的,以便早期诊断和适当治疗。
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Rhizopus microsporus pulmonary sepsis: Case report and review of literature
The incidence of opportunistic fungal infection, mucormycosis associated with high mortality rate is steadily increasing. Pulmonary mucormycosis though rare, it relatively affects individuals with diabetes mellitus and other immunosuppressive conditions. The present study reports on case of pulmonary mucormycosis caused by Rhizopus microsporus. Sputum sample was collected from a 47-year-old male with diagnosed with tuberculosis with spontaneous left sided pneumothorax and diabetes mellitus. The positive fungal culture was characterized by phenotypic and genotypic methods and antifungal susceptibility of the isolate was tested against azoles and amphotericin B. The etiological agent was identified as R. microsporus based on phenotypic features and molecular sequencing of ITS. The isolate was susceptible to all the tested antifungal and the patient responded well to Amphotericin B with strict glycemic control and combination of anti-infective therapy. Though pulmonary mucormycosis is relatively rare; it share its clinical picture with pulmonary tuberculosis and aspergillosis, hence clinical suspicion for mucormycosis in susceptible high risk patients is warranted for early diagnosis and appropriate therapy.
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