{"title":"一个中国肺毛霉病队列的诊断、临床特征和死亡危险因素。","authors":"Junjun Wan, Teng Liu, Fang Li, Shaohua Xu","doi":"10.1371/journal.pone.0323624","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pulmonary mucormycosis is a rare and often fatal fungal infection. Identifying high-risk factors for pulmonary mucormycosis holds the potential to improve patient outcomes. This study aimed to identify the clinical characteristics and risk factors associated with pulmonary mucormycosis outcomes in a Chinese cohort.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on 37 patients diagnosed with pulmonary mucormycosis, focusing on clinical records, laboratory findings, and computed tomography (CT) imaging. Diagnosis was primarily based on histopathology or next-generation sequencing.</p><p><strong>Results: </strong>The median age of the patients was 55 years, and the most common underlying conditions were hematological malignancies, diabetes, and organ transplantation. Imaging frequently revealed bilateral lung involvement with ground-glass opacities and nodular lesions. The overall mortality rate was 29.7%, with significant risk factors for 90-day mortality including hypertension (Hazard Ratio [HR] = 3.36, 95% Confidence Interval [CI] = 1.01-11.12, P = 0.048), organ transplantation (HR = 4.93, 95% CI = 1.48-16.4, P = 0.009), and immunosuppression (HR = 8.83, 95% CI = 1.13-69.14, P = 0.038).</p><p><strong>Conclusions: </strong>Early suspicion and timely diagnostic measures, such as biopsy or metagenomic sequencing, are crucial for improving patient outcomes. These findings underscore the importance of recognizing and managing pulmonary mucormycosis in high-risk populations.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0323624"},"PeriodicalIF":2.6000,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083791/pdf/","citationCount":"0","resultStr":"{\"title\":\"Diagnosis, clinical features, and mortality risk factors in a Chinese cohort with pulmonary mucormycosis.\",\"authors\":\"Junjun Wan, Teng Liu, Fang Li, Shaohua Xu\",\"doi\":\"10.1371/journal.pone.0323624\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Pulmonary mucormycosis is a rare and often fatal fungal infection. Identifying high-risk factors for pulmonary mucormycosis holds the potential to improve patient outcomes. This study aimed to identify the clinical characteristics and risk factors associated with pulmonary mucormycosis outcomes in a Chinese cohort.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on 37 patients diagnosed with pulmonary mucormycosis, focusing on clinical records, laboratory findings, and computed tomography (CT) imaging. Diagnosis was primarily based on histopathology or next-generation sequencing.</p><p><strong>Results: </strong>The median age of the patients was 55 years, and the most common underlying conditions were hematological malignancies, diabetes, and organ transplantation. Imaging frequently revealed bilateral lung involvement with ground-glass opacities and nodular lesions. The overall mortality rate was 29.7%, with significant risk factors for 90-day mortality including hypertension (Hazard Ratio [HR] = 3.36, 95% Confidence Interval [CI] = 1.01-11.12, P = 0.048), organ transplantation (HR = 4.93, 95% CI = 1.48-16.4, P = 0.009), and immunosuppression (HR = 8.83, 95% CI = 1.13-69.14, P = 0.038).</p><p><strong>Conclusions: </strong>Early suspicion and timely diagnostic measures, such as biopsy or metagenomic sequencing, are crucial for improving patient outcomes. 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引用次数: 0
摘要
背景:肺毛霉病是一种罕见且经常致命的真菌感染。确定肺毛霉病的高危因素具有改善患者预后的潜力。本研究旨在确定中国队列中与肺毛霉菌病预后相关的临床特征和危险因素。材料与方法:回顾性分析37例肺毛霉菌病患者的临床记录、实验室表现和CT影像。诊断主要基于组织病理学或下一代测序。结果:患者的中位年龄为55岁,最常见的基础疾病是血液系统恶性肿瘤、糖尿病和器官移植。影像学常显示双侧肺受累伴磨玻璃样混浊和结节性病变。总死亡率为29.7%,90天死亡率的显著危险因素包括高血压(危险比[HR] = 3.36, 95%可信区间[CI] = 1.01 ~ 11.12, P = 0.048)、器官移植(危险比[HR] = 4.93, 95% CI = 1.48 ~ 16.4, P = 0.009)和免疫抑制(危险比= 8.83,95% CI = 1.13 ~ 69.14, P = 0.038)。结论:早期怀疑和及时诊断措施,如活检或宏基因组测序,对改善患者预后至关重要。这些发现强调了在高危人群中识别和管理肺毛霉病的重要性。
Diagnosis, clinical features, and mortality risk factors in a Chinese cohort with pulmonary mucormycosis.
Background: Pulmonary mucormycosis is a rare and often fatal fungal infection. Identifying high-risk factors for pulmonary mucormycosis holds the potential to improve patient outcomes. This study aimed to identify the clinical characteristics and risk factors associated with pulmonary mucormycosis outcomes in a Chinese cohort.
Materials and methods: A retrospective analysis was conducted on 37 patients diagnosed with pulmonary mucormycosis, focusing on clinical records, laboratory findings, and computed tomography (CT) imaging. Diagnosis was primarily based on histopathology or next-generation sequencing.
Results: The median age of the patients was 55 years, and the most common underlying conditions were hematological malignancies, diabetes, and organ transplantation. Imaging frequently revealed bilateral lung involvement with ground-glass opacities and nodular lesions. The overall mortality rate was 29.7%, with significant risk factors for 90-day mortality including hypertension (Hazard Ratio [HR] = 3.36, 95% Confidence Interval [CI] = 1.01-11.12, P = 0.048), organ transplantation (HR = 4.93, 95% CI = 1.48-16.4, P = 0.009), and immunosuppression (HR = 8.83, 95% CI = 1.13-69.14, P = 0.038).
Conclusions: Early suspicion and timely diagnostic measures, such as biopsy or metagenomic sequencing, are crucial for improving patient outcomes. These findings underscore the importance of recognizing and managing pulmonary mucormycosis in high-risk populations.
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