Challa Sundaram, Uppin Shantveer G, Uppin Megha S, Paul Roshni T, Prayaga Aruna K, Rao Manmadha T
Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India.
Lung India. 2011 Jan;28(1):25-9. doi: 10.4103/0970-2113.76297.
Zygomycosis is an emerging infection worldwide. Pulmonary zygomycosis (PZ) is uncommon with only few reported series from India.
All cases of PZ diagnosed on histopathology between 1995 and 2008 were included. Clinical and imageological findings were noted in all cases. Routine hematoxylin and eosin-stained sections were studied to assess the pathology; Gomori's methenamine silver (GMS), periodic acid Schiff were done for delineating fungal morphology. Culture reports were collected wherever available. Treatment and outcome details were noted.
Seven patients were diagnosed with PZ during the study period, which included six males and one female patient. Six of these had diabetes mellitus (DM) and one patient was on chemotherapy for the treatment of Hodgkin's lymphoma. Fever and cough were the most common presenting features. Consolidation with or without cavitation was seen in six patients and lung abscess with fungal ball in one patient. All six patients with DM had upper lobe involvement and four had multiple lesions. Histological sections revealed necrotizing inflammation, hemorrhagic infarcts and angioinvasion. Culture was available in two patients, which grew Rhizopus oryzae. Five patients succumbed to disease and remaining two were lost to follow-up.
Diabetes mellitus is the most common predisposing factor for PZ and carries high mortality.
接合菌病在全球范围内是一种新出现的感染性疾病。肺接合菌病（PZ）并不常见，印度仅有少数系列报道。
纳入1995年至2008年间经组织病理学诊断的所有PZ病例。记录所有病例的临床和影像学表现。研究常规苏木精和伊红染色切片以评估病理情况；采用Gomori六胺银染色（GMS）、过碘酸希夫染色来描绘真菌形态。 wherever available收集培养报告。记录治疗及转归细节。
研究期间有7例患者被诊断为PZ，其中包括6例男性和1例女性患者。这些患者中有6例患有糖尿病（DM），1例患者正在接受化疗以治疗霍奇金淋巴瘤。发热和咳嗽是最常见的临床表现。6例患者可见实变伴或不伴空洞形成，1例患者可见肺脓肿伴真菌球。所有6例糖尿病患者均有上叶受累，4例有多处病变。组织学切片显示坏死性炎症、出血性梗死和血管侵袭。2例患者有培养结果，培养出米根霉。5例患者死亡，其余2例失访。
糖尿病是PZ最常见的易感因素，且死亡率高。
