Clinical Characteristics and Diagnostic Methods of Pulmonary Mucormycosis
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20221201.001
- VernacularTitle:肺毛霉菌病的临床特征及诊断方法
- Author:
Hai-hong CHEN
1
;
Wei-ping TAN
1
;
Hui-min YANG
1
;
Peng-hao GUO
2
;
Zi-yin YE
3
;
Yang-li LIU
1
;
Yu-biao GUO
1
Author Information
1. Division of Pulmonary and Critical Care Medicine， The First Affiliated Hospital of Sun Yat-sen University， Guangzhou 510080， China
2. Department of Clinical Laboratory， The First Affiliated Hospital of Sun Yat-sen University， Guangzhou 510080， China
3. Department of Pathology， The First Affiliated Hospital of Sun Yat-sen University， Guangzhou 510080，China
- Publication Type:Journal Article
- Keywords:
Pulmonary mucormycosis;
Clinical characteristics;
Prognosis;
Diagnosis;
Metagenomic Next-generation Sequencing
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2023;44(1):175-180
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo summarize the clinical features and prognosis of pulmonary mucormycosis （PM） in southern China， and to explore the diagnostic value of metagenomic next generation sequencing （mNGS） in PM. MethodsThe clinical manifestations， diagnosis， treatment and prognosis of patients diagnosed with PM in The First Affiliated Hospital of Sun Yat-sen University from January 1， 2019 to January 31， 2022 who had undergone mNGS detection in lung tissue or alveolar lavage fluid were collected retrospectively. A total of 14 patients with PM were included， including 4 patients with confirmed diagnosis and 10 patients with clinical diagnosis. ResultsAll patients had underlying medical conditions， with hematological malignancies and diabetes being the most common. The most common symptoms were fever （n = 10）， cough （n = 9） and shortness of breath （n = 9）. Consolidation was the most common sign of chest CT， followed by mass， mostly with cavity. On laboratory tests， decreased CD4+T lymphocytes， elevated CD8+T lymphocytes， and decreased CD4+/CD8+ ratio， and presentation with pleural effusion indicate poor prognosis. The positive rate of mNGS diagnosis was 78.5%， which was significantly higher than that of histopathology （50%）， fungus rapid fluorescence staining （61.5%） and fungal culture （23.1%） of bronchoalveolar lavage fluid. ConclusionsPulmonary mucormycosis is more likely to occur in patients with underlying diseases or who are immunocompromised. The clinical manifestations lack specificity. The low CD4/CD8 ratio and presentation of pleural effusion on CT imaging indicate poor prognosis of patients. mNGS is a rapid， convenient and sensitive method for the diagnosis of PM， which has advantages in the diagnosis of pulmonary mucormycosis.
