Mucormycosis in systemic autoimmune diseases |
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| Affiliation: | 1. Service de rhumatologie, CHU d’Angers, 49933 Angers cedex 9, France;2. Inserm U1016, CNRS UMR 8104, institut Cochin, Paris, France;3. National Referral Center for Rare Systemic Autoimmune Diseases hôpital Cochin, Assistance Publique–Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France;1. Department of Rheumatology, Roger Salengro Hospital, Lille 2 University, 59037 Lille, France;2. Department of Rheumatology, Saint-Philibert Hospital, Lille Catholic University, 59160 Lomme, France;3. Department of Internal Medicine, Taaone Hospital, Papeete, French Polynesia;2. Department of Anesthesia, University of Maryland School of Medicine, Baltimore, MD;3. Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY;4. Department of Cardiothoracic Surgery, Mount Sinai Medical Center, New York, NY;1. Department of Anaesthesia and Intensive Care Medicine, Royal Alexandra Hospital, Paisley PA2 9PN, UK;2. Institute of Care and Practice Improvement, University of the West of Scotland, Paisley PA1 2BE, UK;1. Division of Hematology/Oncology, Department of Clinical Medicine, Saint George Hospital University Medical Center, Beirut, Lebanon;2. Department of Pathology, Saint George Hospital University Medical Center, Beirut, Lebanon;3. Division of Infectious Disease, Department of Clinical Medicine, Saint George Hospital University Medical Center, Beirut, Lebanon |
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| Abstract: | Mucormycosis is an emerging infection in systemic autoimmune diseases. All published cases of systemic autoimmune diseases complicated by mucormycosis were reviewed. The clinical features, diagnostic procedures and the main principles of treatment were analyzed. Twenty-four cases of mucormycosis have been reported in systemic auto-immune diseases, of which 83% in systemic lupus erythematosus, all occurring during immunosuppressants. In most cases, the infection was disseminated or rhinocerebral and it had mimicked a flare of the underlying connective tissue disease. A fatal outcome was reported in 58.3% of these patients. In conclusion, mucormycosis often mimics a flare of the underlying systemic disease and is associated with a high mortality rate. Systemic lupus erythematosus is by far the most common associated systemic autoimmune disease. A high degree of awareness is warranted to rapidly rule out infection, of which mucormycosis, in immunocompromised patients with systemic autoimmune disease before a disease flare is conclusively diagnosed. |
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| Keywords: | Mucormycosis Opportunistic infections Immunosuppressive drugs Systemic autoimmune diseases |
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