PDF(Pubmed)
Abstract：
UNASSIGNED: Pulmonary mucormycosis is a rare but rapidly progressive fatal disease. Limited data exist on the outcomes and factors associated with poor prognosis of pulmonary mucormycosis. The objective of this study was to evaluate clinical characteristics, factors associated with mortality, and outcomes of pulmonary mucormycosis at a tertiary care hospital in Pakistan.
UNASSIGNED: This was a retrospective observational study conducted at a tertiary care hospital in Karachi, Pakistan. Medical records of hospitalized patients diagnosed with proven or probable pulmonary mucormycosis between January 2018 and December 2022 were reviewed. Univariate and regression analyses were performed to identify factors associated with mortality.
UNASSIGNED: Fifty-three pulmonary mucormycosis patients (69.8% male) were included, with mean age of 51.19 ± 21.65 years. Diabetes mellitus was the most common comorbidity [n = 26 (49.1%)]. Chronic lung diseases were present in [n = 5 (9.4%)], and [n = 16 (30.2%)] had concurrent coronavirus disease 2019 (COVID-19) pneumonia. The predominant isolated Mucorales were Rhizopus [n = 32 (60.3%)] and Mucor species [n = 9 (17%)]. Main radiological findings included consolidation [n = 39 (73.6%)] and nodules [n = 14 (26.4%)]. Amphotericin B deoxycholate was prescribed in [n = 38 (71.7%)], and [n = 14 (26.4%)] of patients received combined medical and surgical treatment. The median [interquartile range (IQR)] hospital stay was 15.0 (10.0-21.5) days. Intensive care unit (ICU) care was required in [n = 30 (56.6%)] patients, with 26 (49.1%) needing mechanical ventilation. Overall mortality was seen in 29 (54.7%) patients. Significantly higher mortality was found among patients requiring mechanical ventilation 20/29 (69%, p = 0.002). Immunosuppression (p = 0.042), thrombocytopenia (p = 0.004), and mechanical ventilation (p = 0.018) were identified as risk factors for mortality on multivariable analysis.
UNASSIGNED: This study provides essential insights into the clinical characteristics, outcomes, and mortality factors associated with pulmonary mucormycosis. The mortality rate was high (54.7%), particularly in patients with immunosuppression, thrombocytopenia, and those who required mechanical ventilation.
UNASSIGNED: This was a retrospective observational study conducted at a tertiary care hospital in Karachi, Pakistan. Medical records of hospitalized patients diagnosed with proven or probable pulmonary mucormycosis between January 2018 and December 2022 were reviewed. Univariate and regression analyses were performed to identify factors associated with mortality.
UNASSIGNED: Fifty-three pulmonary mucormycosis patients (69.8% male) were included, with mean age of 51.19 ± 21.65 years. Diabetes mellitus was the most common comorbidity [n = 26 (49.1%)]. Chronic lung diseases were present in [n = 5 (9.4%)], and [n = 16 (30.2%)] had concurrent coronavirus disease 2019 (COVID-19) pneumonia. The predominant isolated Mucorales were Rhizopus [n = 32 (60.3%)] and Mucor species [n = 9 (17%)]. Main radiological findings included consolidation [n = 39 (73.6%)] and nodules [n = 14 (26.4%)]. Amphotericin B deoxycholate was prescribed in [n = 38 (71.7%)], and [n = 14 (26.4%)] of patients received combined medical and surgical treatment. The median [interquartile range (IQR)] hospital stay was 15.0 (10.0-21.5) days. Intensive care unit (ICU) care was required in [n = 30 (56.6%)] patients, with 26 (49.1%) needing mechanical ventilation. Overall mortality was seen in 29 (54.7%) patients. Significantly higher mortality was found among patients requiring mechanical ventilation 20/29 (69%, p = 0.002). Immunosuppression (p = 0.042), thrombocytopenia (p = 0.004), and mechanical ventilation (p = 0.018) were identified as risk factors for mortality on multivariable analysis.
UNASSIGNED: This study provides essential insights into the clinical characteristics, outcomes, and mortality factors associated with pulmonary mucormycosis. The mortality rate was high (54.7%), particularly in patients with immunosuppression, thrombocytopenia, and those who required mechanical ventilation.
摘要：
■肺毛霉菌病是一种罕见但快速进展的致命疾病。关于肺毛霉菌病预后不良的结果和相关因素的数据有限。这项研究的目的是评估临床特征，与死亡率相关的因素，以及巴基斯坦三级医院的肺毛霉菌病结果。
■这是一项在卡拉奇三级医院进行的回顾性观察研究，巴基斯坦。回顾了2018年1月至2022年12月期间诊断为已证实或可能的肺毛霉菌病的住院患者的医疗记录。进行单因素和回归分析以确定与死亡率相关的因素。
■包括53例肺毛霉菌病患者（69.8％为男性），平均年龄51.19±21.65岁。糖尿病是最常见的合并症[n=26(49.1%)]。慢性肺部疾病出现在[n=5(9.4%)]，[n=16（30.2%）]患有2019年冠状病毒病（COVID-19）肺炎。主要分离的毛霉是根霉[n=32（60.3％）]和毛霉[n=9（17％）]。主要放射学发现包括巩固[n=39（73.6％）]和结节[n=14（26.4％）]。[n=38（71.7％）]中开了两性霉素B脱氧胆酸盐，[n=14（26.4％）]的患者接受了内科和外科综合治疗。中位[四分位距（IQR）]住院时间为15.0（10.0-21.5）天。[n=30（56.6%）]患者需要重症监护病房（ICU）护理，26人（49.1%）需要机械通气。29例（54.7%）患者出现总死亡率。在需要机械通气20/29的患者中发现了更高的死亡率（69％，p=0.002)。免疫抑制（p=0.042），血小板减少症（p=0.004），和机械通气(p=0.018)在多变量分析中被确定为死亡的危险因素.
■这项研究提供了对临床特征的基本见解，结果，和与肺毛霉菌病相关的死亡因素。死亡率高(54.7%),特别是在免疫抑制患者中，血小板减少症,和那些需要机械通气的人。
■这是一项在卡拉奇三级医院进行的回顾性观察研究，巴基斯坦。回顾了2018年1月至2022年12月期间诊断为已证实或可能的肺毛霉菌病的住院患者的医疗记录。进行单因素和回归分析以确定与死亡率相关的因素。
■包括53例肺毛霉菌病患者（69.8％为男性），平均年龄51.19±21.65岁。糖尿病是最常见的合并症[n=26(49.1%)]。慢性肺部疾病出现在[n=5(9.4%)]，[n=16（30.2%）]患有2019年冠状病毒病（COVID-19）肺炎。主要分离的毛霉是根霉[n=32（60.3％）]和毛霉[n=9（17％）]。主要放射学发现包括巩固[n=39（73.6％）]和结节[n=14（26.4％）]。[n=38（71.7％）]中开了两性霉素B脱氧胆酸盐，[n=14（26.4％）]的患者接受了内科和外科综合治疗。中位[四分位距（IQR）]住院时间为15.0（10.0-21.5）天。[n=30（56.6%）]患者需要重症监护病房（ICU）护理，26人（49.1%）需要机械通气。29例（54.7%）患者出现总死亡率。在需要机械通气20/29的患者中发现了更高的死亡率（69％，p=0.002)。免疫抑制（p=0.042），血小板减少症（p=0.004），和机械通气(p=0.018)在多变量分析中被确定为死亡的危险因素.
■这项研究提供了对临床特征的基本见解，结果，和与肺毛霉菌病相关的死亡因素。死亡率高(54.7%),特别是在免疫抑制患者中，血小板减少症,和那些需要机械通气的人。
