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恶性外耳炎和骨骨质炎的罕见原因
Freya Harding1, David Howlett2, Muhannad Al-Hashim1
1Otolaryngology, East Sussex Healthcare NHS Trust, Eastbourne, UK.
概括
这项案例研究突出了罕见的真菌头骨基骨质炎 (SBO) 在糖尿病患者最初治疗恶性外耳炎 (MOE). 早期怀疑真菌感染对于及时诊断和有效的抗真菌治疗至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 菌类学 菌类学是指菌类学.
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 恶性外耳炎 (MOE) 和骨骨质炎 (SBO) 是严重的感染,通常是由 Pseudomonas引起的.
- 2型糖尿病可增加对机会性真菌感染的易感性.
研究的目的:
- 在2型糖尿病患者中报告Scedosporium apiospermum引起的罕见真菌SBO病例.
- 强调在耐火MOE和SBO中考虑真菌病因的重要性.
主要方法:
- 用临床表现和诊断成像 (CT和MRI) 来评估感染的程度.
- 对液体采集的微生物学分析发现了Scedosporium apiospermum.
- 治疗涉及经验性抗生素,其次是向性抗真菌疗法,使用voriconazole.
主要成果:
- 患者最初出现了暗示MOE和SBO的症状,对西普洛素没有反应.
- 感染被证实是由于Scedosporium apiospermum的真菌SBO.
- 沃里康纳治疗导致显著的临床和放射性改善.
结论:
- 在免疫功能低下的患者中,尤其是糖尿病患者中,应怀疑真菌SBO,呈现出渐进或治疗不良的MOE/SBO.
- 由于在获得真菌SBO的微生物学确认方面存在挑战,诊断可能会出现延迟.
- Scedosporium apiospermum 是一种罕见但重要的真菌SBO的原因,需要特殊的抗真菌治疗.
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