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Yanli LI, Liqiong LIU, Dailing Yan, Yaji YANG, YANGFang, YANG ShengRong OU, Yanhong LIU. Clinical Characteristics, Diagnosis and Treatment of Diabetes Mellitus with Pulmonary Mucormycosis[J]. Journal of Kunming Medical University. doi: 10.12259/j.issn.2095-610X.S20220108
Citation: Yanli LI, Liqiong LIU, Dailing Yan, Yaji YANG, YANGFang, YANG ShengRong OU, Yanhong LIU. Clinical Characteristics, Diagnosis and Treatment of Diabetes Mellitus with Pulmonary Mucormycosis[J]. Journal of Kunming Medical University. doi: 10.12259/j.issn.2095-610X.S20220108

Clinical Characteristics, Diagnosis and Treatment of Diabetes Mellitus with Pulmonary Mucormycosis

doi: 10.12259/j.issn.2095-610X.S20220108
  • Received Date: 2021-11-16
  •   Objective  To explore the risk factors, clinical symptoms, diagnosis and treatment of pulmonary mucormycosis (PM) so as to improve the diagnostic rate of PM and reduce the mortality.   Methods  4 patients (2 females and 2 males) with pulmonary mucormycosis confirmed by pathology in the First Department of Respiratory and Critical Care Medicine of Yan'an Hospital of Kunming City from January 2011 to August 2021 were collected and their clinical data, risk factors, clinical symptoms, imaging findings, treatment and prognosis were analyzed.   Results  All 4 patients were complicated with type 2 diabetes, 1 patient with hypertension, 1 patient with chronic renal failure and was treated with long-term oral hormone therapy. The main chest imaging findings were mainly patchy, patchy high-density shadows and bronchial lumen stenosis. All the 4 patients were diagnosed as PM by pathological biopsy. After the diagnosis, 1 patient died of massive hemoptysis, 2 patients were treated with systemic antifungal drugs combined with bronchoscopic intervention and 1 patient was treated with bronchoscopic intervention due to intolerance to systemic antifungal therapy. The clinical symptoms of the 3 patients were improved significantly after the treatment.   Conclusion  PM is a rare invasive fungal disease, which occurs frequently in patients with diabetes, renal failure and immune deficiency. The clinical symptoms are lack of specificity, and the diagnosis mainly depends on the etiology and histological examination. Our clinical experience suggests that antifungal drugs combined with bronchoscopic interventional therapy can improve the outcomes of patients with PM, but further expanded sample size is still needed to observe the efficacy of the treatment.
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  • [1]
    Guinea J,Escribano P,Vena A,et al. Increasing incidence of mucormycosis in a large Spanish hospital from 2007 to 2015:Epidemiology and microbiological characterization of the isolates[J]. PLos One,2017,12(6):e0179136. doi: 10.1371/journal.pone.0179136
    [2]
    Kontoyiannis D P,Wessel V C,Bodey G P,et al. Zygomycosis in the 1990s in a tertiary-care cancer center[J]. Clin Infect Dis,2000,30(6):851-856. doi: 10.1086/313803
    [3]
    Tedder M,Spratt J A,Anstadt M P,et al. Pulmonary mucormycosis:Results of medical and surgical therapy[J]. Ann Thorac Surg,1994,57(4):1044-1050. doi: 10.1016/0003-4975(94)90243-7
    [4]
    Chamilos G,Lewis R E,Kontoyiannis D P. Delaying amphotericin B-based frontline therapy significantly increases mortality among patients with hematologic malignancy who have zygomycosis[J]. Clin Infect Dis,2008,47(4):503-509. doi: 10.1086/590004
    [5]
    Linden P K. Amphotericin B lipid complex for the treatment of invasive fungal infections[J]. Expert Opin Pharmacother,2003,4(11):2099-2110. doi: 10.1517/14656566.4.11.2099
    [6]
    中华医学会呼吸病学分会感染学组, 中华结核和呼吸杂志编辑委员会. 肺真菌病诊断和治疗专家共识[S]. 中华结核和呼吸杂志, 2007, 30(11): 821-834.
    [7]
    梁志欣, 金芬华, 余丹阳等. 5例病理确诊的肺毛霉菌病临床分析[J]. 临床肺科杂志, 2012, 17(3): 418-420.
    [8]
    Cohen-Abbo A,Bozeman P M,Patrick C C. Cunninghamella infections:Review and report of two cases of Cunninghamella pneumonia in immunocompromised children[J]. Clin Infect Dis,1993,17(2):173-177. doi: 10.1093/clinids/17.2.173
    [9]
    Rüping M J,Heinz W J,Kindo A J,et al. Forty-one recent cases of invasive zygomycosis from a global clinical registry[J]. J Antimicrob Chemother,2010,65(2):296-302. doi: 10.1093/jac/dkp430
    [10]
    Pozo Laderas J C,Pontes Moreno A,Pozo Salido C,et al. Disseminated mucormycosis in immunocompetent patient:A disease that also exsists[J]. Rev Iberoam Micol,2015,32(2):63-70. doi: 10.1016/j.riam.2014.01.006
    [11]
    Farmakiotis D,Kontoyiannis D P. Mucormycoses[J]. Infect Dis Clin North Am,2016,30(1):143-163. doi: 10.1016/j.idc.2015.10.011
    [12]
    Lee F Y,Mossad S B,Adal K A. Pulmonary mucormycosis:The last 30 years[J]. Arch Intern Med,1999,159(12):1301-1309. doi: 10.1001/archinte.159.12.1301
    [13]
    Feng J,Sun X. Characteristics of pulmonary mucormycosis and predictive risk factors for the outcome[J]. Infection,2018,46(4):503-512. doi: 10.1007/s15010-018-1149-x
    [14]
    Danion F,Aguilar C,Catherinot E,et al. Mucormycosis:New developments into a persistently devastating infection[J]. Semin Respir Crit Care Med,2015,36(5):692-705. doi: 10.1055/s-0035-1562896
    [15]
    Chitasombat M N,Kontoyiannis D P. Treatment of mucormycosis in transplant patients:Role of surgery and of old and new antifungal agents[J]. Curr Opin Infect Dis,2016,29(4):340-345. doi: 10.1097/QCO.0000000000000277
    [16]
    邓莉萍, 杨莹, 邓治平. 支气管镜下注入两性霉素B脂质体治疗肺毛霉菌病 [J]. Chinese Journal of Respiratory and Critical Care Medicine, 2018, 17(4): 416-417.
    [17]
    Mihara T,Kakeya H,Izumikawa K,et al. Efficacy of aerosolized liposomal amphotericin B against murine invasive pulmonary mucormycosis[J]. J Infect Chemother,2014,20(2):104-108. doi: 10.1016/j.jiac.2013.09.002
    [18]
    Panigrahi M K,Manju R,Kumar S V,et al. Pulmonary mucormycosis presenting as nonresolving pneumonia in a patient with diabetes mellitus[J]. Respiratory Care,2014,59(12):201-205. doi: 10.4187/respcare.03205
    [19]
    Virally M L,Riveline J P,Virally J,et al. Pulmonary mucormycosis in a diabetic patient with HIV[J]. Diabetes Care.,2002,25(11):2105. doi: 10.2337/diacare.25.11.2105
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