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Deep Fungal Infection- An Emerging Problem in Bangladesh

机译:深部真菌感染-孟加拉国一个新出现的问题

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Objective: Invasive deep fungal infections have become a major cause of morbidity and mortality over the past three decades. Organ transplantation, the use of aggressive chemotherapy and the availability and widespread use of immunosuppressive treatments for many medical ailments have resulted in large populations of patients who are at risk of fungal infections. We report our experience to increase awareness of the clinical spectrum of disseminated fungal infection and its similarity to other infections and malignancy. Materials and Methods: Case reports from different medical institution for last 6 months were searched through case registry and recent scientific presentation and publications. Results: Recently a case of Histoplasmosis was reported in Dhaka Medical College Hospital (DMCH) where a 57 years old male presented with low grade fever for 3 months, backache followed by progressive weakness of both lower limbs , there was spastic paraplegia with sensory loss upto the level of D10. An open biopsy from paravertebral soft tissue showed histopathological features consistent with histoplasmosis. Other deep fungal infections e.g. pulmonary blastomycoses, mucormycoses and pulmonary aspergilloma were also reported in DMCH and Bangabandhu Shiekh Mujib Medical University (BSMMU) and RMCH. Conclusion: As these fungal infections are not commonly encountered in our country and most of the dissemination has similar clinical features of chronic inflammatory process and malignancy, we need a high index of suspicion to diagnose with different diagnostic approach. Bangladesh may be experiencing increase load of disseminated fungal infections and awareness is now very important to explore its underlying aetiology.
机译:目的:在过去的三十年中,侵入性深部真菌感染已成为发病率和死亡率的主要原因。器官移植,积极化学疗法的使用以及免疫抑制疗法在许多医学疾病中的可获得性和广泛使用已导致大量患者面临真菌感染的风险。我们报告我们的经验,以提高人们对散播性真菌感染的临床范围及其与其他感染和恶性肿瘤相似性的认识。资料和方法:通过病例登记表和最新的科学报告和出版物,检索了不同医疗机构最近6个月的病例报告。结果:最近在达卡医学院医院(DMCH)报道了一例组织胞浆菌病,其中一名57岁的男性表现为低烧3个月,腰酸继而下肢进行性无力,出现痉挛性截瘫,感觉丧失至D10的级别。椎旁软组织的开放活检显示与组织胞浆菌病相一致的组织病理学特征。其他深部真菌感染在DMCH,Bangabandhu Shiekh Mujib医科大学(BSMMU)和RMCH中也报告了肺泡母细胞增多症,黏液黏膜病和肺曲霉病。结论:由于这些真菌感染在我国并不常见,并且大多数传播具有类似慢性炎症过程和恶性肿瘤的临床特征,因此我们需要高度怀疑的指标才能用不同的诊断方法进行诊断。孟加拉国可能正在传播越来越多的真菌感染,现在了解其潜在病因非常重要。

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