Abstract：
Pulmonary mucormycosis is a rare but highly lethal fungal infection, usually affecting immunocompromised patients. Pulmonary mucormycosis was also a critical problem that complicated the later part of the clinical course of COVID-19 in India. Early diagnosis of the disease, combined with aggressive treatment, is crucial for patient survival. Fibreoptic bronchoscopy is a useful procedure for diagnosis of pulmonary mucormycosis, but image-guided percutaneous biopsy efficiently samples lesions abutting the chest wall. Biopsy is more yielding than cultures and imaging guided biopsy is required for lesions that cannot be microbiologically confirmed by fibreoptic bronchoscopy. We present a case series of four patients of pulmonary mucormycosis in whom ultrasound guided biopsy clinched the diagnosis. All the four patients were poor surgical candidates and underwent medical management with antifungal agents, and had successful clinical recovery and radiological resolution. Our case series illustrates the utility of ultrasound guided percutaneous biopsy as a diagnostic tool for sampling cavitatory disease due to pulmonary mucormycosis, when fibreoptic bronchoscopy failed to yield a diagnosis and the beneficial role antifungal agents as salvage therapy in poor surgical candidates.
摘要：
肺毛霉菌病是一种罕见但高度致命的真菌感染，通常影响免疫功能低下的患者。肺毛霉菌病也是印度COVID-19临床病程后期的一个关键问题。疾病的早期诊断，结合积极的治疗，对患者生存至关重要。纤维支气管镜检查是诊断肺毛霉菌病的有用方法。但是图像引导的经皮穿刺活检可以有效地采样与胸壁相邻的病变。活检比培养更有效，并且对于无法通过纤维支气管镜进行微生物学确认的病变，需要成像引导活检。我们介绍了一系列四例肺毛霉菌病患者，其中超声引导下的活检获得了诊断。所有四名患者均为不良手术候选人，并接受了抗真菌药物的医疗管理，并有成功的临床恢复和放射学分辨率。我们的病例系列说明了超声引导经皮活检作为诊断工具的实用性，用于对由于肺毛霉菌病引起的空洞疾病进行采样，当纤维支气管镜检查未能做出诊断时，抗真菌药在不良手术候选人中作为挽救治疗的有益作用。
