Резюме
Definition
病史和体格检查
关键诊断因素
- sinus and facial pain
- eye pain, blurred vision
- proptosis
- cranial nerve palsies
- dry cough, with or without dyspnea
- skin nodules
其他诊断因素
- fever
- periorbital cellulitis
- viscid, dark brown-black nasal discharge
- focal sensory/motor neurologic deficits and altered mental status
- necrotic eschar
- hemoptysis
- abdominal pain and distension
- gastrointestinal bleeding
- peritonitis
危险因素
- diabetes mellitus ± diabetic ketoacidosis
- hematologic malignancy
- neutropenia
- iron overload or use of deferoxamine
- use of corticosteroids
- hematopoietic and solid organ transplantation, graft-versus-host disease
- breakdown of skin and soft tissue
- malnutrition
- prematurity
- liver cirrhosis
诊断性检查
首要检查
- CBC
- basic metabolic profile
- ABG
- urinalysis
- serum ketone level
- CT sinuses and brain
- MRI sinuses and brain
- CT chest with contrast
- nasal endoscopy
- gastrointestinal endoscopy
需考虑的检查
- bronchoscopy with bronchoalveolar lavage and/or transbronchial biopsy fungal culture
- histopathology of biopsy
- microbiology of biopsy
新兴检查
- polymerase chain reaction (PCR)
治疗流程
suitable for surgery
unsuitable for surgery
treatment failure
撰稿人
作者
Rachana M. Palnitkar, MD
Infectious Diseases
Private Practice
Los Gatos
CA
利益声明
RMP declares that she has no competing interests.
Michael Sands, MD, MPH & TM, FIDSA
Professor of Medicine
College of Medicine
University of Florida
Jacksonville
FL
利益声明
MS declares that he has no competing interests.
同行评议者
Michail Lionakis, MD, ScD
Infectious Diseases Fellow
Laboratory of Molecular Immunology
National Institute of Allergy and Infectious Diseases
NIH
Bethesda
MD
利益声明
ML declares that he has no competing interests.
Rachael Morris-Jones, PhD, FRCP, PCME
Dermatology Consultant and Honorary Senior Lecturer
Kings College Hospital
London
UK
利益声明
RMJ declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Pham D, Howard-Jones AR, Sparks R, et al. Epidemiology, modern diagnostics, and the management of mucorales infections. J Fungi (Basel). 2023 Jun 12;9(6):659.全文 摘要
Spellberg B, Edwards J Jr, Ibrahim A. Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev. 2005 Jul;18(3):556-69.全文 摘要
Centers for Disease Control and Prevention. Mucormycosis: clinical overview of mucormycosis. Apr 2024 [internet publication].全文
Cornely OA, Alastruey-Izquierdo A, Arenz D, et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis. 2019 Dec;19(12):e405-21.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Aspergillosis
- Bacterial sinusitis
- Bacterial periorbital cellulitis
更多 鉴别诊断指南
- Global guideline for the diagnosis and management of mucormycosis
- Global guideline for the diagnosis and management of mucormycosis
更多 指南
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