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Report of 12 cases with tracheobronchial mucormycosis and a review

机译：治地区粘液膜12例报告及综述

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摘要

Abstract Objectives Tracheobronchial mucormycosis is a rare and invasive pulmonary mucormycosis involving the tracheobronchial tree. Data source At a 3500‐bed tertiary care center. Study Selection This was a retroactive study of 12 cases of tracheobronchial mucormycosis diagnosed in our hospital, and 48 cases that were previously reported in the English literature. Results Rhizopus was the predominant species of pathogen (66.7%). Primary bronchus was the most frequently involved location (38.2%), and upper lobes (51% of cases) were a predilection. Obstructive necrosis and mucosal necrosis were the most common pathological forms (40% and 34.5%, respectively). Fever (59.3%), cough (59.3%), dyspnea (40.7%) and hemoptysis (30.5%) were the most common symptoms. 51.4% patients had rales, 40% had moist rales and 28.6% had negative physical findings. Ninety‐five percent patients had immunosuppressive diseases. Diabetes mellitus (66.7%), diabetes ketoacidosis (21.7%), corticosteroid therapy (20%) and kidney insufficiency (18.3%) were the most common predisposing factors. 13.2% had neutropenia which was mostly among the non‐diabetic patients ( P ?=?.006). Endobronchial lesion of 23.2% had imaging reports with 33.9% exhibiting single mass. Pathological diagnosis of 76.7% used the transbronchial biopsy. The most frequent antifungal therapies were intravenous amphotericin B (79.7%), surgery (33.3%) and surgery combined with amphotericin B therapy (28.3%). Overall in‐hospital mortality was 52.5%, with hemoptysis ( P ?=?.017), dyspnea at presentation ( P ?=?.022) and angioinvasion ( P ?=?.03) as independent risk prognostic factors. In contrast, surgery ( P ?=?.003) was an independent protection prognostic factor. Conclusions Tracheobronchial mucormycosis is a rare but severe disease with high mortality because of its nonspecific clinical presentations and variable predisposing factors.
机译：摘要目的气管阳脉粘液瘤病是一种难以兴奋的肺粘膜，涉及气管中的树木。 3500床三级护理中心的数据源。学习选择这是我们医院诊断患病的12例气管支出粘膜病的追溯性研究，并在英国文学中报告了48例。结果Rhizopus是病原体的主要种类（66.7％）。主要支气管是最常见的位置（38.2％），上裂片（51％的病例）是偏好。阻塞性坏死和粘膜坏死是最常见的病理形式（分别为40％和34.5％）。发烧（59.3％），咳嗽（59.3％），呼吸困难（40.7％）和咯血（30.5％）是最常见的症状。 51.4％的患者患有戒律，40％患有潮湿的rales，28.6％有阴性的物理结果。百分之九十五的患者有免疫抑制疾病。糖尿病（66.7％），糖尿病酮症症（21.7％），皮质类固醇治疗（20％）和肾功能不全（18.3％）是最常见的易感因素。 13.2％有中性粒细胞病，主要是非糖尿病患者（P？= 006）。 23.2％的内核病变有33.9％的成像报告，表现出单一质量。病理诊断为76.7％使用跨晶体活组织检查。最常见的抗真菌疗法是静脉内两性蛋白B（79.7％），手术（33.3％）和手术与两性霉素B治疗合并（28.3％）。患有血液岩（P？=β.017），呼吸困难（P？= 022）和血管基因（p？=Δ.03）作为独立风险预后因素的呼吸困难。相比之下，手术（p？=Δ.003）是一个独立的保护预后因素。结论气管藻霉霉菌病是一种罕见但严重的疾病，具有高死亡率，因为其非特异性临床介绍和可变的易感因素。

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  • 来源
    《The clinical respiratory journal.》 |2018年第4期|共10页
  • 作者

    He Ruoxi; Hu Chengping; Tang Yongjun; Yang Huaping; Cao Liming; Niu Ruichao;

  • 作者单位

    Department of Respiratory MedicineXiangya Hospital (Key Cite of National Clinical Research Center;

    Department of Respiratory MedicineXiangya Hospital (Key Cite of National Clinical Research Center;

    Department of Respiratory MedicineXiangya Hospital (Key Cite of National Clinical Research Center;

    Department of Respiratory MedicineXiangya Hospital (Key Cite of National Clinical Research Center;

    Department of Respiratory MedicineXiangya Hospital (Key Cite of National Clinical Research Center;

    Department of Respiratory MedicineXiangya Hospital (Key Cite of National Clinical Research Center;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 呼吸系及胸部疾病;
  • 关键词

    amphotericin B; fugus; Rhizopus; tracheobronchial mucormycosis;

    机译：两性霉素B;Fugus;Rhizopus;气管藻霉菌;

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