Retrospective analysis of pulmonary zygomycosis in mainland China：a review of 102 cases

Abstract

Abstract:

Objective To investigate the epidemiology and clinical characteristics of pulmonary zygomycosis in mainland China.Methods Literatures about pulmonary zygomycosis in China were collected from the electrical databases, such as CNKI, CJDF, VIP, Chinese physician full-text journals, and also Pubmed since 1988. Then all the data were analyzed with the SPSS 15.0 software.Results Seventy-three articles (102 cases) were included in the study. Median age was 48.4 (range, 0.003-84) years old, with a male predominance (M：F=2.46). In China, patients with diabetes, HIV infection, viral hepatitis, and long-term utilization of corticosteroid and/or immunosuppressants, were more susceptible to pulmonary zygomycosis. Without specific clinical and radiographic features, its diagnosis was mainly dependent on mycologic and/or histopathological examination. Amphotericin B was the first-line antifungal drug for pulmonary zygomycosis, and better efficacy could be got if combined with surgical treatment.Conclusions In recent years, there is an increasing trend in the prevalence of pulmonary zygomycosis in mainland china. For highly suspected pulmonary zygomycosis, it's necessary to initiate early anti-fungal therapy, and combined surgical treatment may improve the outcome.

Key words: Zygomycosis, Mucor, pulmonary infection, China

CLC Number:

R519.8

ZHAO Jing-yu, WANG Gui-zhen, ZHANG Jun-yong, YANG Ya-li, JIA Hong-ling, FANG Wei, PAN Wei-hua, LIAO Wan-qing. Retrospective analysis of pulmonary zygomycosis in mainland China：a review of 102 cases[J]. Chinese Journal of Mycology, 2014, 9(3): 150-154.

References

[1] Chayakulkeeree M, Ghannoum MA, Perfect JR. Zygomycosis: the re-emerging fungal infection[J]. Eur J Clin Microbiol Infect Dis,2006,25(4): 215-229.
[2] Spellberg B, Edwards J Jr, Ibrahim A. Novel perspectives on mucormycosis: pathophysiology, presentation, and management[J]. Clin Microbiol Rev,2005,18(3): 556-569.
[3] Bitar D, Van Cauteren D, Lanternier F, et al. Increasing incidence of zygomycosis (mucormycosis), France, 1997-2006[J]. Emerg Infect Dis,2009,15(9): 1395-1401.
[4] Bitar D, Van Cauteren D, Lanternier F, et al. Increasing incidence of zygomycosis (mucormycosis), France, 1997-2006[J]. Emerg Infect Dis,2009,15(9): 1395-1401.
[5] Roden MM, Zaoutis TE, Buchanan WL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases[J]. Clin Infect Dis,2005,41(5): 634-653.
[6] Rees JR, Pinner RW, Hajjeh RA,et al. The epidemiological features of invasive mycotic infections in the San Francisco Bay area, 1992-1993: results of population-based laboratory active surveillance[J]. Clin Infect Dis,1998,27(5): 1138-1147.
[7] De Pauw B, Walsh TJ, Donnelly JP, et al. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group[J]. Clin Infect Dis,2008,46(12): 1813-1821.
[8] Li WF, He C, Liu XF, et al. A diagnosis neglected for 6 years: report of a misdiagnosed case of pulmonary mucormycosis and review of the literature[J]. Chin Med J (Engl),2010,123(17): 2480-2482.
[9] 于进洪, 李军涛. 肺蛙粪霉菌病1例[J]. 疑难病杂志,2010,(08): 627.[ZK)]
[10] 余进, 万喆, 鲁巧云, 等. 白血病患者伞枝犁头霉感染二例[J]. 中华检验医学杂志,2010,33(2): 173-174.
[11] Greenberg RN, Scott LJ, Vaughn HH, Ribes JA. Zygomycosis (mucormycosis): emerging clinical importance and new treatments[J]. Curr Opin Infect Dis,2004,17(6): 517-525.
[12] McAdams HP, de Christenson M R, Strollo DC, Patz EF Jr. Pulmonary mucormycosis: radiologic findings in 32 cases[J].Am J Roentgenol,1997,168(6): 1541-1548.
[13] Jamadar DA, Kazerooni EA, Daly BD, et al. Pulmonary zygomycosis: CT appearance[J]. J Comput Assist Tomogr,1995,19(5): 733-738.
[14] Chamilos G, Marom EM, Lewis RE, et al. Predictors of pulmonary zygomycosis versus invasive pulmonary aspergillosis in patients with cancer[J]. Clin Infect Dis,2005,41(1): 60-66.
[15] Dannaoui E, Meletiadis J, Mouton JW, Meis JF, Verweij PE. In vitro susceptibilities of zygomycetes to conventional and new antifungals[J]. J Antimicrob Chemother,2003,51(1): 45-52.
[16] Singh J, Rimek D, Kappe R. In vitro susceptibility of 15 strains of zygomycetes to nine antifungal agents as determined by the NCCLS M38-A microdilution method[J]. Mycoses,2005,48(4): 246-250.
[17] Sun QN, Fothergill AW, McCarthy DI, et al. In vitro activities of posaconazole, itraconazole, voriconazole, amphotericin B, and fluconazole against 37 clinical isolates of zygomycetes[J]. Antimicrob Agents Chemother,2002,46(5): 1581-1582.
[18] Greenberg RN, Mullane K, van Burik JA, et al. Posaconazole as salvage therapy for zygomycosis[J]. Antimicrob Agents Chemother,2006,50(1): 126-133.
[19] van Burik JA, Hare RS, Solomon HF, et al. Posaconazole is effective as salvage therapy in zygomycosis: a retrospective summary of 91 cases[J]. Clin Infect Dis,2006,42(7): e61-65.
[20] Gonzalez CE, Rinaldi MG, Sugar AM. Zygomycosis[J]. Infect Dis Clin North Am,2002,16(4): 895-914,vi.