5例病理确诊的肺毛霉菌病临床分析

Clinical analysis of 5 patients with pathologically diagnosed pulmonary mucormycosis

目的探讨肺毛霉菌病的临床特征。方法经病理确诊的5例肺毛霉菌病患者的临床资料进行分析。结果 4例患者分别合并糖尿病、支气管扩张、肺结核等基础疾病,咳嗽(3/4)、咳痰(3/4),发热(3/4),咯血(3/4)是常见的临床症状,胸部影像学表现为多发斑片状病灶3例,多发空洞病灶1例,单一团块病灶1例,病灶伴有空洞形成4例。治疗结果为痊愈1例,好转2例,死亡1例,无法判断1例。结论肺毛霉菌病临床罕见,临床表现与影像学特征缺乏特异性,患者多并存基础疾病,对具有高危因素的患者早期进行病理组织学检查对改善肺毛霉菌病患者预后具有重要价值。

Objective To investigate the clinical features of pulmonary mucormycosis. Methods Retrospective analysis was performed on the clinical data in 5 patients with pathologically diagnosed pulmonary mucormycosis in General Hospital of Chinese People＇s Liberation Army from January 1991 to December 2010. Results g patients suffered from diabetes, bronehiectasis, tuberculosis and other underlying diseases. Cough （3/4）, expectoration （3/4）, fever （3/4） and hemoptysis （3/4） were the most common symptoms. Chest imaging showed multiple patchy lesions in 3 cases, multiple eavitary lesions in 1 case, a single mass lesion in 1 case, and lesions associat- ed with cavity formation in g cases. 1 patient was cured, 2 patients were improved, 1 patient died and the outcome could not be judged in 1 patient. Conclusions Pulmonary mucormycosis is a rare disease and the clinical manifestation and image feature were not specific. At- tention should be paid to the patients with underlying diseases and high risk factors. Histopathological examination was necessary for the early diagnosis of pulmonary mucormycosis and may improve survival.