Clinical diagnostics features of pulmonary mucormycosis and literature review

Abstract

Objective To enhance the recognition of pulmonary mucormycosis(PM) by analyzing the clinical symptoms, imaging features, diagnosis, treatment and prognosis of this disease. Methods The clinical data of 6 patients suffering from PM during January 2007 and December 2015 were retrospectively analyzed and the related literatures were reviewed. Results All these 6 cases were elderly patients, course of disease was 26 days to 14 months.One patient had no underlying diseases, 1 patient had pulmonary tuberculosis, 1 patient had COPD history, 1 patients had immune thrombocytopenia, 3 patients had high blood glucose and 1 of the 3 patients had diabetic ketoacidosis during development of PM.The clinical symptoms included cough, expectoration, fever, hemoptysis, etc.Imaging features showed that 2 cases had mass and nodules in double lung, 1 cases had multiple patchy shadow in double lung, single mass lesions with holes in 2 cases, double lung nodules with cavity in 1 case, pleural effusion in 3 cases, pericardial effusion in 2 cases.Amphotericin B or liposomal amphotericin B was used in all the patients for therapy, and symptoms of 5 cases improved.Posaconazole was used as combined therapy in 1 cases complicated with cerebral mucormycosis.The symptoms of the lung improved but the patients died at last. Conclusions The clinical and imaging features of the PM are lack of specificity.Bronchoscopy or lung biopsy is an effective method for the diagnosis of PM.Early diagnosis, control of underlying diseases, timely application of amphotericin B are the key of its treatment. Key words: Pulmonary mucormycosis; Signs and symptoms; Imaging; Amphotericin B