Mukormikosis Rino-Orbito-Serebral pada Diabetes Melitus

Aivi Mujono, Elizabeth Feloni Lukito, Meiliyana Wijaya

Abstract

Mukormikosis rino-orbito-serebral (ROS) adalah penyakit angioinvasif akibat infeksi jamur Mucorales yang sering ditemukan pada pasien diabetes melitus (DM). Penyakit ini memiliki gambaran khas jaringan nekrotik kehitaman disebut eschar, sehingga disebut juga infeksi “jamur hitam”. Tingkat mortalitas penyakit ini tinggi terutama jika diagnosis dan tata laksana terlambat. Patogenesis mukormikosis ROS pada pasien DM antara lain: interaksi reseptor sel epitel dengan protein jamur, kadar besi bebas dalam darah, dan penurunan imunitas seluler. Diagnosis berdasarkan gambaran klinis dengan faktor risiko, identifikasi jamur, dan pencitraan. Pemeriksaan histopatologis dari jaringan biopsi dapat dikonfirmasi dengan hasil kultur. Tata laksana mukormikosis ROS pada penderita DM meliputi kombinasi debridemen, pemberian antijamur, dan mengatasi kondisi hiperglikemia.

 

Rhino-orbital-cerebral mucormycosis (ROCM) is an angioinvasive disease caused by Mucorales fungal infection; it is common in diabetes mellitus (DM) patients. The disease has a characteristic feature of black necrotic appearance called eschar, thus also called as “black fungus” infection.
The mortality rate of this disease is high, especially in delayed diagnosis and treatment. The pathogenesis of ROCM in diabetic patients includes the interaction of epithelial cell receptors with fungal proteins, free iron blood levels, and decreased cellular immunity. Diagnosis is based on
clinical features, supporting risk factors, fungus identification, and imaging. Histopathological examination on biopsy tissue confirmed by culture can establish the diagnosis. Management includes a combination of surgical debridement, antifungals, and glycemia control.

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