Abstract
Fungal infections have become crucial factors that threaten the prognosis and survival of blood disease patients. Here, we aim to analyze the epidemiological characteristics and early and advanced CT (computed tomography) manifestations of patients with invasive pulmonary fungal infections secondary to blood system diseases. 65 hospitalized patients from October 2018 to October 2020 with invasive pulmonary fungal infections secondary to blood diseases were enrolled. Blood diseases were recorded according to clinical and imaging data, and the serum galactomannan test (GM test) was conducted. Two senior radiologists analyzed the CT data and recorded the distribution of the lesions and CT signs. We analyzed and counted the first chest CT scan images of patients with nodule/mass type secondary to hematological diseases and invasive pulmonary fungal infection. The first CT nodules or mass-type lesions were statistically significant in nodule size, the number of lesions, distribution, and accompanying signs. Pulmonary fungal infection was common in both lungs during 7-day, 14-day, and 30-day follow-up CT. We also found that the nodular mass type was the main manifestation in the positive group of the GM test. Both the positive group and the negative group had the highest incidence of nodules. The incidence of air crescent signs in nodules or mass lesions in the positive group was higher than in the negative group, and the difference was statistically significant. To conclude, follow-up CT signs after antifungal treatment were highly sensitive to the early diagnosis of hematological diseases and secondary invasive pulmonary Eumycetes infection, which could be used for clinical treatment to provide help. GM test results were also related to CT manifestations such as air crescent sign, cavity, and halo sign.
Highlights
Hematological diseases, such as leukemia, lymphoma, severe aplastic anemia (SAA), and hematopoietic stem cell transplantation (HSCT), are prone to secondary blood system abnormalities caused by bone marrow transplantation or immunocompromised stage and other diseases [1]
In 65 patients with invasive pulmonary fungal infection secondary to hematological diseases, the first chest CT scan was performed, and the CT image signs were recorded in two major types, namely, the nodule type and mixed type (CT signs include two or more), for statistics. ere were 40 cases of nodule/mass type and 25 cases of mixed type, including 2 cases of ground glass, 9 cases of atelectasis, 7 cases of interstitial inflammation, and 7 cases of tree bud sign
Lin et al have reviewed the epidemiology of the invasive fungal disease in patients with hematological diseases [11] and pointed out that the secondary fungal infection was one of the main factors leading to the death of patients with hematological diseases
Summary
Hematological diseases, such as leukemia, lymphoma, severe aplastic anemia (SAA), and hematopoietic stem cell transplantation (HSCT), are prone to secondary blood system abnormalities caused by bone marrow transplantation or immunocompromised stage and other diseases [1]. Deep fungal infections and secondary fungal infections have become important factors affecting the prognosis and survival of blood disease patients [2]. E author focuses on reviewing the status quo of imaging studies of pulmonary fungal infections secondary to blood diseases. E incidence of deep fungal diseases has risen sharply in the past two centuries. A survey of 115 hospitals in the United States showed that the fungal infection rate in the 1990s was 1.9 times that of the 1980s. Another scholar reported that the incidence of fungal infection in 2004 was 214 times that of the 1990s. Yamazaki et al reported that the incidence of fungi in patients with acute myeloid leukemia (AML), acute lymphocytic leukemia
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