Practical Experience of Anti-infection Treatment in a Patient with Diabetic Ketoacidosis Accompanied by Pulmonary Mucormycosis
Objective:To analyze the clinical diagnosis and treatment process of a patient with diabetic ketoacidosis accompanied by mucormycosis,and to provide reference for the diagnosis and treatment of patients with such complicated infection.Methods and Results:The patient was admitted to the hospital due to"cough and expectoration for 1 week".However,the next day,due to the critical value in the blood glucose report,the patient was considered diabetic ketoacidosis,and was transferred to a higher hospital for treatment.The patient's chest CT showed pulmonary infection,so doxycycline+cefoperazone sulbactam sodium+amikacin was given empirically.However,after more than ten days of anti-infection treatment,the infection was still controlled poorly,so experts were invited for consultation.Experts considered a high possibility of fungal infection in the patient,so amphotericin B for injection was added,and then fungal clumps(preferring mucor)were found in the bronchial mucosa tissue.Later,the anti-infection treatment regimen was adjusted to amphotericin B cholesterol sulfate complex for injection+posaconazole suspension oral liquid+cefoperazone sulbactam sodium.However,after more than one month of anti-infection treatment,the infection was still not completely controlled,so the clinical pharmacist was invited for consultation,who suggested adjusting the anti-infection treatment regimen to isavuconazole for injection+meropenem based on the patient's condition,previous medication and relevant diagnosis and treatment guidelines,and the doctor adopted the suggestion.After that,the cough,expectoration,fever and other infectious symptoms of the patient were significantly relieved,and chest CT also showed that the lung lesions were obviously absorbed.Conclusion:For complicated and refractory infectious diseases,the possibility of fungal infection should be fully considered in clinical practice,and the pathogen should be actively explored.In targeted treatment,the varieties and dosage forms of drugs should also be optimized,and their efficacy should be observed in real time to ensure timely and effective treatment on patients.
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