본문 바로가기
KERD
논문KCI 등재

Diagnostic Challenges of Mucormycosis in a Patient with Diabetes: A Case Report

0

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류미생물학

초록

Mucormycosis is a rare and life-threatening fungal infection that predominantly affects immunocompromised individuals, particularly those with poorly controlled diabetes mellitus. Achieving an accurate diagnosis remains a significant challenge in clinical practice. We report a case of mucormycosis in a 25-year-old woman who presented with an altered mental status and a 5 × 2 cm necrotic lesion on the left nasal septum, characterized by indistinct borders, during admission. Prolonged diagnostic investigations ultimately led to the identification of nasal mucormycosis attributable to Rhizomucor pusillus, a rare species within the Mucorales order, which complicates the diagnostic process. Unfortunately, the patient's clinical condition rapidly deteriorated, resulting in her demise prior to the administration of systemic antifungal therapy. Although the comprehensive evaluations facilitated the identification of the causative agent, the time required for this process did not favor the patient's prognosis. The atypical symptoms, swift progression, and infrequent occurrence of mucormycosis underscore the critical importance of its timely and accurate diagnosis to ensure favorable patient outcomes. Proper identification of the pathogen and immediate administration of therapeutic interventions can considerably enhance the likelihood of patient recovery and survival.

Abstract

Mucormycosis is a rare and life-threatening fungal infection that predominantly affects immunocompromised individuals, particularly those with poorly controlled diabetes mellitus. Achieving an accurate diagnosis remains a significant challenge in clinical practice. We report a case of mucormycosis in a 25-year-old woman who presented with an altered mental status and a 5 × 2 cm necrotic lesion on the left nasal septum, characterized by indistinct borders, during admission. Prolonged diagnostic investigations ultimately led to the identification of nasal mucormycosis attributable to Rhizomucor pusillus, a rare species within the Mucorales order, which complicates the diagnostic process. Unfortunately, the patient's clinical condition rapidly deteriorated, resulting in her demise prior to the administration of systemic antifungal therapy. Although the comprehensive evaluations facilitated the identification of the causative agent, the time required for this process did not favor the patient's prognosis. The atypical symptoms, swift progression, and infrequent occurrence of mucormycosis underscore the critical importance of its timely and accurate diagnosis to ensure favorable patient outcomes. Proper identification of the pathogen and immediate administration of therapeutic interventions can considerably enhance the likelihood of patient recovery and survival.

참고문헌 (11)

  1. Skiada A, "Challenges in the diagnosis and treatment of mucormycosis", Med Mycol, 56, pp.S93~S101 (2018)
  2. Ponnaiyan D, "Mucormycosis diagnosis revisited : current and emerging diagnostic methodologies for the invasive fungal infection(Review)", Exp Ther Med, 25, pp.47~ (2022)
  3. Hernandez JL, "StatPearls" (2023), StatPearls Publishing
  4. Singh AK, "Mucormycosis in COVID-19 : a systematic review of cases reported worldwide and in India", Diabetes Metab Syndr, 15, pp.102146~ (2021)
  5. Reid G, "Mucormycosis", Semin Respir Crit Care Med, 41, pp.99~114 (2020)
  6. Walsh TJ, "Necrotizing mucormycosis of wounds following combat injuries, natural disasters, burns, and other trauma", J Fungi(Basel), 5, pp.57~ (2019)
  7. Smith BE, "Focal and entrapment neuropathies", Handb Clin Neurol, 126, pp.31~43 (2014)
  8. Walsh TJ, "Larone's medically important fungi: a guide to identification" (2018), ASM Press
  9. Alastruey-Izquierdo A, "Activity of posa-conazole and other antifungal agents against Mucorales strains identified by sequencing of internal transcribed spacers", Antimicrob Agents Chemother, 53, pp.1686~1689 (2009)
  10. Passi N, "Radiological spectrum of invasive mucormycosis in COVID-19", BJR Case Rep, 7, pp.20210111~ (2022)
  11. Pai V, "Rhino-orbitocerebral mucormycosis : pictorial review", Insights Imaging, 12, pp.167~ (2021)

관련 논문AI추천

Fatal Pulmonary Mucormycosis Caused by Rhizopus microsporus in a Patient with Diabetes김경희, 김문진, 박미정, 박필환, 서일혜, 서자영, 안정열, 정지훈, 정진우대한진단검사의학회 · Annals of Laboratory Medicine2014 · 제34권 제1호Risk Factors for Mortality in Patients with Invasive Mucormycosis김탁, 김미나, 김성한, 김양수, 우준희, 이상오, 이유미, 이주영, 정유삼, 최상호, 홍효림대한감염학회 · Infection and Chemotherapy2013 · 제45권 제3호Importance of immediate surgical intervention and antifungal treatment for rhinocerebral mucormycosis: a case report남웅, 김진근, 김형준, 박정현, 박혜정, 백지웅, 차인호대한구강악안면외과학회 · 대한구강악안면외과학회지2013 · 제39권 제5호Identification of Mucorales From Clinical Specimens: A 4-Year Experience in a Single Institution기창석, 김영권, 양미나, 이남용, 이장호, 허희재대한진단검사의학회 · Annals of Laboratory Medicine2016 · 제36권 제1호면역저하 환자에서 발생한 털곰팡이증에 의한 비중격 및 구강 농양 1예강주창, 성한경, 위지혜대한이비인후과학회 · 대한이비인후과학회지 두경부외과학2019 · 제62권 제9호Rhino-orbito-cerebral Mucormycosis: Etiopathology, Clinical Features, Outcome, and the Factors Associated with OutcomeAmit Kumar Deb, Arun Alexander, Rakesh Singh, Sandip Sarkar, Subashini Kaliaperumal, Tanmay Gokhale대한안과학회 · Korean Journal of Ophthalmology2022 · 제36권 제4호

이 간행물의 다른 논문 (8건)