Beginning >> Diseases >> Infectious >> Mukoroz


Mukoroz treats group of the infections caused by mushrooms from a class of phycomycetes of the sort Mucor. To pathogenic for the person Absidia, Rhizopus and Mucor belong. They live in the soil, grow on fruit and other foodstuff (for example, a bread mold). Mukoraliya well grow on laboratory mediums, forming white, gray or brown color a mold if are incubated at a temperature of 37 °C. In appropriately painted clinical sample the mushroom hyphas which are unevenly branching at right angle are well visible. Mukoroz represents a serious invasive illness: the mushroom burgeons through fabrics.
Epidemiology. Disputes mukoraliyev meet everywhere, but the disease develops seldom. It appears sporadic. Children with heavy main pathology (the diabetes mellitus which is especially followed by acidosis, a leukosis, a lymphoma) get sick almost only. The disease quite often develops against treatment by immunodepressive drugs, after an organ transplantation, heavy burns or children with insufficiency have functions of kidneys and dystrophy. Recently flashed unusual epidemic of a skin mukoroz was connected with wide use of bandages from elastoplastic.
Clinical manifestations. Infection occurs at hit dispute of a mushroom to the gastrointestinal or respiratory highway. Burgeoning, disputes affect mucous membranes of a nasopharynx, a trachea or a stomach and intestines. The rinotserebralny form typical for suffering from a noncompensated diabetes mellitus is most widespread. The disease begins with emergence of a black scab in the nasal courses or on a hard palate. Gradually there is a growth of floccuses of a mushroom to damage of adnexal bosoms of a nose. Further growth leads to damage of nervous trunks, blood vessels, a cartilaginous and bone tissue, a meninx and tissue of a brain. Orbits, the person and all adjacent bodies are involved in process. The symptomatology is shown by pain in the respective area, a unilateral headache, a congestion in a nose, numbness of the person and nasal bleedings in the beginning. When progressing process periorbital fabrics inflame, there is a ptosis, the movements of eyes are broken and there comes the blindness. Growth of a mushroom in a head cavity leads to occlusion of intracranial arteries and veins. On the roentgenogram of a skull find intensive blackout of adnexal bosoms of a nose, then a caries in the beginning. By means of a computer tomography reveal a disease of eye-sockets. The diagnosis is established on the basis of allocation of floccuses of a mushroom in a fabric bioptata. At cultural research positive takes receive only in 15% of cases.
Mukoroz of lungs — a serious, life-threatening illness. Children with reduced body resistance and the suppressed immune responses, patients with a leukosis and with lymphoma after inhalation litter of a mushroom get sick mainly. It can be combined with a rinotserebralny form. At the isolated damage of lungs at patients often observe the heart attack them caused by germination and occlusion of pulmonary vessels. The symptomatology consists in sharply developed fevers, stethalgias of pleural character and a blood spitting. Further quite often there comes hematogenous dissimination of process in many bodies. Radiographic research allows to reveal diverse and nonspecific changes in lungs. Find focal and infiltrative shadows, blackouts of the whole lung lobes, band changes and accumulation of a pleural exudate. It was reported also about nodular forms of a disease, formation of mycetomas and massive volume processes. Establishment of the diagnosis requires histologic research of pulmonary fabric what it is necessary to make a puncture transthoracic, transbronchial or open biopsy of a lung for.
The gastrointestinal form of a mukoroz meets rather seldom. Its development in children usually is associated with dystrophy and malnutrition, a kwasiorkor or treatment by corticosteroids. Necrotic ulcers can be widespread on all digestive tract, especially in a stomach. Serve as symptoms of a disease sharply developing diarrhea with blood impurity to Calais, impassability or perforation of intestines.
Disseminated mukoroz develops at children with heavy general pathology (a leukosis, a lymphoma) it is frequent against the accompanying infection other types of pathogenic bacteriums, viruses and mushrooms. Comes to an end usually letalno. In the beginning the infection is most often localized in lungs, then disseminates. Neurologic manifestations are connected with involvement in process of vessels of a brain. The disease of meningeal covers meets seldom, but in cerebrospinal fluid there is slightly expressed pleocytosis with dominance of polymorphonuclear neutrophils, protein level against not changed glucose level increases. Results of crops of blood and cerebrospinal fluid are always negative. The diagnosis is established on the basis of results of a biopsy of the damaged fabrics.
Skin mukoroz represents the secondary disease developing after extensive burns or surgical interventions. As symptoms serve the erythematic plaques which are exposed to an ulceration with education in the center of a black scab. The diagnosis manages to be made at crops, a biopsy and histologic research of suspicious sites of skin.
Multi-infection is shown by an endocarditis, a necrosis of a brain and a disease of kidneys.
Treatment. At a mukoroza treatment consists in intensive actions concerning the basic disease weakening body resistance, reduction of a dose or cancellation of immunodepressive drugs, surgical removal of the struck fabrics and intravenous administration of Amphotericinum of Century. The optimum dose it for children is not established. At treatment of adults with the started forms drug appoint in a daily dose 30 — 40 mg/kg within 2 — 3 months. At superficial diseases of skin excision of a site of defeat and topical treatment by Amphotericinum of Century are effective. Nevertheless this patients are recommended to carry out also system treatment by drug, considering deep germination of a mushroom in fabric.

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