Sun H-Y, Aguado J M, Bonatti H, Forrest G, Gupta K L, Safdar N, John G T, Pursell K J, Muñoz P, Patel R, Fortun J, Martin-Davila P, Philippe B, Philit F, Tabah A, Terzi N, Chatelet V, Kusne S, Clark N, Blumberg E, Julia M B, Humar A, Houston S, Lass-Florl C, Johnson L, Dubberke E R, Barron M A, Lortholary O, Singh N
VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Am J Transplant. 2009 Sep;9(9):2166-71. doi: 10.1111/j.1600-6143.2009.02754.x. Epub 2009 Jul 22.
Fifty-eight solid organ transplant recipients with zygomycosis were studied to assess the presentation, radiographic characteristics, risks for extra-pulmonary dissemination and mortality of pulmonary zygomycosis. Pulmonary zygomycosis was documented in 31 patients (53%) and developed a median of 5.5 months (interquartile range, 2-11 months) posttransplantation. In all, 74.2% (23/31) of the patients had zygomycosis limited to the lungs and 25.8% (8/31) had lung disease as part of disseminated zygomycosis; cutaneous/soft tissue (50%, 4/8) was the most common site of dissemination. Pulmonary disease presented most frequently as consolidation/mass lesions (29.0%), nodules (25.8%) and cavities (22.6%). Patients with disseminated disease were more likely to have Mycocladus corymbifer as the causative pathogen. The mortality rate at 90 days after the treatment was 45.2%. In summary, pulmonary zygomycosis is the most common manifestation in solid organ transplant recipients with zygomycosis, and disseminated disease often involves the cutaneous/soft tissue sites but not the brain.
对58例患有接合菌病的实体器官移植受者进行了研究，以评估肺接合菌病的临床表现、影像学特征、肺外播散风险及死亡率。31例患者（53%）确诊为肺接合菌病，发病时间中位数为移植后5.5个月（四分位间距为2 - 11个月）。总体而言，74.2%（23/31）的患者接合菌病局限于肺部，25.8%（8/31）的患者肺部疾病是播散性接合菌病的一部分；皮肤/软组织（50%，4/8）是最常见的播散部位。肺部疾病最常见的表现为实变/肿块病变（29.0%）、结节（25.8%）和空洞（22.6%）。播散性疾病患者更有可能以伞枝犁头霉作为致病病原体。治疗后90天的死亡率为45.2%。总之，肺接合菌病是实体器官移植受者接合菌病最常见的表现形式，播散性疾病常累及皮肤/软组织部位而非脑部。
