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| COVID-19合并侵袭性肺毛霉菌病成功救治案例与文献综述 |
| Successful treatment cases and literature review of COVID-19 combined with invasive pulmonary mucormycosis |
| 投稿时间：2025-02-22 修订日期：2025-02-22 |
| DOI： |
| 中文关键词: COVID-19 侵袭性肺毛霉菌病 糖尿病酮症 两性霉素B脂质体 支气管镜治疗 宏基因组测序 |
| 英文关键词: COVID-19 invasive pulmonary mucormycosis diabetic ketoacidosis liposomal amphotericin B bronchoscopic treatment metagenomic sequencing |
| 基金项目: |
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| 中文摘要: |
| 背景：侵袭性肺毛霉菌病（PM）是一种罕见但高致死率的机会性感染，COVID-19合并PM（CAM）诊断困难，易误诊漏诊，治疗效果欠佳。本研究报告一例成功救治的CAM患者，并探讨优化诊疗策略。
病例：50岁女性COVID-19合并糖尿病酮症（DKA）及侵袭性肺毛霉菌病。mNGS快速检出小孢根霉，患者接受两性霉素B脂质体（L-AmB）静脉滴注联合气管镜下局部灌注抗真菌治疗，病情显著改善，影像学显示病灶吸收，随访6个月无复发。
结论：mNGS可提高CAM早期诊断率，L-AmB局部与全身联合治疗在改善预后方面具有重要价值。早期诊断、多模式抗真菌治疗及个体化管理是提高CAM生存率的关键。 |
| 英文摘要: |
| Background Invasive pulmonary mucormycosis (PM) is a rare but highly fatal fungal infection, posing diagnostic and therapeutic challenges in COVID-19-associated mucormycosis (CAM).
Case Report A 50-year-old female with COVID-19 and diabetic ketoacidosis (DKA) developed invasive PM. Metagenomic next-generation sequencing (mNGS) identified Rhizopus microsporus. The patient received systemic liposomal amphotericin B (L-AmB) and local bronchoscopic instillation, leading to significant clinical and radiological improvement. No recurrence was observed at 6-month follow-up.
Conclusion mNGS enhances early CAM diagnosis, while L-AmB combined systemic and local therapy is crucial for optimizing clinical outcomes. Early pathogen detection and multimodal antifungal strategies should be emphasized in managing CAM. |
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