Samarei Reza, Gharebaghi Naser, Zayer Salar
Department of Otolaryngology, Faculty of Medicine, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran.
Department of Infectious Diseases, Urmia University of Medical Sciences, Urmia, Iran.
Mycoses. 2017 Jul;60(7):426-432. doi: 10.1111/myc.12614. Epub 2017 Mar 20.
Mucormycosis is a deadly invasive fungal infection and mainly affects immunocompromised patients. To investigate the clinical features of patients who developed mucormycosis and to determine the parameters, which influenced the outcome following mycotic infection. The current investigation retrospectively evaluated the demographic characteristics, clinical features, therapeutic data, as well as the outcomes of treatment in all cases of proven and probable mucormycosis diagnosed from 2002 until 2016 in our hospital. A total of thirty cases were recorded. Rhizopus spp. was the predominant pathogen among the identified Mucorales (26.7%). Diabetes mellitus (46.7%) and haematological malignancy (40%), were the most common underlying diseases. With regard to predisposing factors, neutropenia (43.3%) and chemotherapy (40%) were the leading concomitant parameters. The most frequent sites of infection were lung (30%) and sinus (26.7%), whereas disseminated infection was also found in nine of 30 patients (30%). Neutropenia remained the only independent factor associated with mortality (Relative Risk=3.557, 95% CI=1.365-9.271, P=.009). Diagnostic delay -either due to delayed presentation of patients to our centre or insufficient awareness about invasive fungal infection among our clinicians- is a likely explanation for such a high mortality rate in our series.
毛霉病是一种致命的侵袭性真菌感染,主要影响免疫功能低下的患者。旨在调查发生毛霉病患者的临床特征,并确定影响真菌感染后预后的参数。本研究回顾性评估了2002年至2016年在我院确诊的所有确诊和疑似毛霉病病例的人口统计学特征、临床特征、治疗数据以及治疗结果。共记录了30例病例。根霉属是已鉴定的毛霉目中的主要病原体(26.7%)。糖尿病(46.7%)和血液系统恶性肿瘤(40%)是最常见的基础疾病。关于诱发因素,中性粒细胞减少(43.3%)和化疗(40%)是主要的伴随参数。最常见的感染部位是肺部(30%)和鼻窦(26.7%),而30例患者中有9例(30%)发生了播散性感染。中性粒细胞减少仍然是与死亡率相关的唯一独立因素(相对风险=3.557,95%可信区间=1.365-9.271,P=0.009)。诊断延迟——要么是由于患者到我们中心就诊延迟,要么是我们的临床医生对侵袭性真菌感染认识不足——可能是我们系列中如此高死亡率的一个解释。