CAJ | 학술논문

目的总结近3年收治的5例接合菌病的临床资料,探讨皮肤接合菌病的临床特征、真菌学特征和治疗.方法回顾分析我科近3年收治的5例皮肤接合菌病的临床资料.结果收治的5例皮肤接合菌病,发病年龄5～49岁,男1例,女4例;病程7个月至16年;表现为浅表型1例,坏疽型4例.发病前有外伤或手术史3例,无明显诱因2例.皮损位于面部2例,四肢3例.这5例患者均经过真菌学和(或)病理学确诊.致病真菌为多变根毛霉3例,未鉴定到种2例.治疗以抗真菌药物为主,4例给予两性霉素B治疗,1例给予氟康唑、伊曲康唑胶囊和注射液治疗,治愈2例,好转1例,疗效不佳1例,死亡1例.结论皮肤接合菌病是一种严重的毁容性深部真菌病,提高对本病的认识有助于早期诊断和治疗.治疗首选两性霉素B.
목적 총결근3년수치적5례접합균병적림상자료,탐토피부접합균병적림상특정、진균학특정화치료.방법 회고분석아과근3년수치적5례피부접합균병적림상자료.결과 수치적5례피부접합균병,발병년령5～49세,남1례,녀4례;병정7개월지16년;표현위천표형1례,배저형4례.발병전유외상혹수술사3례,무명현유인2례.피손위우면부2례,사지3례.저5례환자균경과진균학화(혹)병이학학진.치병진균위다변근모매3례,미감정도충2례.치료이항진균약물위주,4례급여량성매소B치료,1례급여불강서、이곡강서효낭화주사액치료,치유2례,호전1례,료효불가1례,사망1례.결론 피부접합균병시일충엄중적훼용성심부진균병,제고대본병적인식유조우조기진단화치료.치료수선량성매소B.
Objective To analyze the clinical characteristics, mycology and therapeutics of 5 cases of cutaneous zygomycosis collected in recent 3 years. Methods A retrospective study was performed using clinical data on 5 cases of cutaneous zygomycosis collected in recent 3 years. Also, previous reports of this entity were reviewed. Results There were 1 male and 4 females among the 5 patients with cutaneous zygo-mycosis confirmed by mycology and/or pathology. The onset of age varied from 5 to 49 years, and course of disease from 7 months to 16 years. Of the 5 patients, 1 presented with superficial cutaneous zygomycosis, and the other 4 with gangrenous cutaneous zygomycosis; 3 had a history of trauma or surgery, 2 had no obvious inducements. Eruptions were located in the face of 2 patients and in the extremities of 3 patients. The isolate was identified as Rhizomucor variabilis in 3 cases, and species remained unclear in 2 cases. Four patients were treated by amphotericin B, and 1 by oral flueonazole as well as oral and injected itraconazole. Finally, 2 patients were healed, 1 was improved, 1 experienced no obvious improvement, and 1 died. Con-clusions Cutaneous zygomycosis is a rare severe devastating deep fungal infection. The first choice of drug is amphoteracin B for it. To improve the understanding of this disease may benefit the early diagnosis and therapy of it.