Abstract
The aim was to better understand the clinical characteristics of patients with mucormycosis in western China. We retrospectively investigated the clinical, laboratory, radiological and treatment profiles of mucormycosis patients during a 10-year period (2010–2019). As a result, 59 proven mucormycosis were enrolled in this study. It was found that 52.5% of patients had worse clinical outcomes. Pulmonary mucormycosis (PM) was the most common clinical manifestation. The most frequent risk factor was diabetes mellitus (38, 64.4%) for mucormycosis patients. Cough (43, 93.5%), fever (24, 52.2%) and hemoptysis/bloody phlegm (21, 45.7%) were the most common manifestations of PM. There were no differences in clinical manifestations, risk factors and laboratory tests between different clinical outcome groups (P>0.05). Lymph node enlargement (30, 65.2%), patchy shadows (28, 60.9%), cavitation (25, 53.3%) and bilateral lobe involvement (39, 84.8%) were the most common on chest CT. Nodule was more common in good outcome group (P <0.05). A total of 48 cases (81.4%) were confirmed by histopathological examination, 22 cases (37.3%) were confirmed by direct microscopy. PM patients were treated with amphotericin B/amphotericin B liposome or posaconazale had better clinical outcomes (P <0.05). In conclusion, PM was the most common clinical type of mucormycosis in China. Diabetes mellitus was the most common risk factor. PM has diverse imaging manifestations and was prone to bilateral lobes involvement. Early diagnosis and effective anti-mucor treatment contribute to successful treatment.
Highlights
Mucormycosis is a rare, emerging and opportunistic fungal infection with high morbidity and mortality caused by filamentous fungi of the Mucoraceae family, order Mucorales
A total of 68 patients with mucormycosis were admitted to our hospital from January 2010 to December 2019, 59 of whom with proven mucormycosis were enrolled in this retrospective study
There was only one case of cutaneous mucormycosis. These patients were classified as pulmonary type and other type mucormycosis based on clinical type
Summary
Mucormycosis is a rare, emerging and opportunistic fungal infection with high morbidity and mortality caused by filamentous fungi of the Mucoraceae family, order Mucorales. The prevalence of mucormycosis varies between developing and developed countries, ranging from 0.01 to 14 per 100 000 population in Europe and India (Bitar et al, 2009; Chakrabarti and Singh, 2014; Ruhnke et al, 2015). The common risk factors of mucormycosis are diabetes, hematological malignancy, use of corticosteroids or immunosuppressants, and trauma (Petrikkos et al, 2014; Jeong et al, 2019). Hematological malignancies are the main cause in countries with high income, while diabetes mellitus (DM) or trauma are the main cause in developing countries (Chakrabarti and Singh, 2014). Diagnosis of mucormycosis is challenging because of the low sensitivity and specificity of clinical diagnostic methods (Skiada et al, 2018)
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