病理确诊的肺毛霉菌病5例临床分析
|
摘要
目的探讨肺毛霉菌病的临床特征、诊治方法。方法 2013年3月—2015年9月分析5例经病理确诊的肺毛霉菌病患者的高危因素、临床特征、治疗方案及预后情况。结果 5例肺毛霉菌病患者,男性3例,女性2例。合并糖尿病2例,血液病1例,肺结核1例。胸部影像学主要表现为实变影、空洞影。治疗结果为治愈4例,死亡1例。结论肺毛霉菌好发于糖尿病、血液系统恶性肿瘤患者。接受两性霉素B抗毛霉菌治疗可改善患者愈后。
Objective To investigate the clinical features, diagnosis and treatment of pulmonary mucormycosis. Methods The risk factors, clinical features, treatment plan and prognosis of 5 patients from March 2013 to September 2015 with pulmonary mucormycosis confirmed by pathology were analyzed. Results 5 patients with pulmonary mucormycosis, 3 males and 2 females. There were 2 cases of diabetes, 1 case of blood disease and 1 case of tuberculosis. Chest imaging was mainly characterized by solid shadows and empty shadows. The treatment results were 4 cases of cure and 1 case of death. Conclusion Pulmonary mucormycosis occurs in patients with diabetes mellitus and hematological malignancies. Treatment with amphotericin B anti-mucomycin can improve the patient's recovery.
Objective To investigate the clinical features, diagnosis and treatment of pulmonary mucormycosis. Methods The risk factors, clinical features, treatment plan and prognosis of 5 patients from March 2013 to September 2015 with pulmonary mucormycosis confirmed by pathology were analyzed. Results 5 patients with pulmonary mucormycosis, 3 males and 2 females. There were 2 cases of diabetes, 1 case of blood disease and 1 case of tuberculosis. Chest imaging was mainly characterized by solid shadows and empty shadows. The treatment results were 4 cases of cure and 1 case of death. Conclusion Pulmonary mucormycosis occurs in patients with diabetes mellitus and hematological malignancies. Treatment with amphotericin B anti-mucomycin can improve the patient's recovery.
引文
[1]Zilberberg MD,Shorr AF,Huang H,et al.Hospital days,hospitalization costs,and inpatient mortality among patients with mucormycosis:a retrospective analysis of US hospital discharge data[J].BMC Infect Dis,2014,14:310-319.
[2]郑华东,杨渭临,崔大江,等.2型糖尿病合并毛霉菌病的临床分析[J].西安交通大学学报:医学版,2016(37):703-707.
[3]Lipatov K,Patel C,Lat T,et a1.Pulmonary Mucormycosis in a Patient With Uncontrolled Diabetes[J].Fed Pract,2018,35(1):32-36.
[4]Lin E,Moua T,Limper AH,et a1.Pulmonary mucormycosis:clinical features and outcomes[J].Infection,2017,45(4):443-448.
[5]贾练,梁宗安,刘丹,等.18例肺毛霉菌病的临床特征与诊治分析[J].实用医院临床杂志,2016,13(1):90-92.
[6]吴挺,周华,周建英,等.肺毛霉菌病25例临床高危因素特征及预后分析[J].中华医学杂志,2018,98(32):2579-2582.
[7]Nam BD,Kim TJ,Lee KS,et al.Pulmonary mucormycosis:serial morphologic changes on computed tomography correlate with clinical and pathologic findings[J].European Radiology,2018,28(2):788-795.
[8]McAdams HP,Rosado de Christenson M,Strollo DC,et a1.Pulmonary mucorrnyeosis:radiologic findings in 32 cases[J].AJR Am J Roentgeno1,1997,168:1541-1548.
[9]Yamamichi T,Horio H,Asakawa A,et al.Surgery for Pulm onary Fungal Infections Complicating Hematological Malignancies[J].Korean J Thorac Cardiovasc Surg,2018,51:350-355.
[10]Ramirez JL,Urisman A,Kukreja J,et al.Surgical Management of Pulmonary Mucormycosis in Third-Trimester Pregnancy[J].Thorac Cardiovasc Surg Rep,2018,7(1):27-29.
[2]郑华东,杨渭临,崔大江,等.2型糖尿病合并毛霉菌病的临床分析[J].西安交通大学学报:医学版,2016(37):703-707.
[3]Lipatov K,Patel C,Lat T,et a1.Pulmonary Mucormycosis in a Patient With Uncontrolled Diabetes[J].Fed Pract,2018,35(1):32-36.
[4]Lin E,Moua T,Limper AH,et a1.Pulmonary mucormycosis:clinical features and outcomes[J].Infection,2017,45(4):443-448.
[5]贾练,梁宗安,刘丹,等.18例肺毛霉菌病的临床特征与诊治分析[J].实用医院临床杂志,2016,13(1):90-92.
[6]吴挺,周华,周建英,等.肺毛霉菌病25例临床高危因素特征及预后分析[J].中华医学杂志,2018,98(32):2579-2582.
[7]Nam BD,Kim TJ,Lee KS,et al.Pulmonary mucormycosis:serial morphologic changes on computed tomography correlate with clinical and pathologic findings[J].European Radiology,2018,28(2):788-795.
[8]McAdams HP,Rosado de Christenson M,Strollo DC,et a1.Pulmonary mucorrnyeosis:radiologic findings in 32 cases[J].AJR Am J Roentgeno1,1997,168:1541-1548.
[9]Yamamichi T,Horio H,Asakawa A,et al.Surgery for Pulm onary Fungal Infections Complicating Hematological Malignancies[J].Korean J Thorac Cardiovasc Surg,2018,51:350-355.
[10]Ramirez JL,Urisman A,Kukreja J,et al.Surgical Management of Pulmonary Mucormycosis in Third-Trimester Pregnancy[J].Thorac Cardiovasc Surg Rep,2018,7(1):27-29.