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通过支气管肺泡灌洗诊断免疫功能正常宿主的肺毛霉菌病。

Pulmonary mucormycosis in immunocompetent hosts diagnosed by bronchioalveolar lavage.

作者信息

Kumar Sunil, Joshi Divya

机构信息

Pathology, KS Hegde Medical Academy, Mangalore, India.

Pathology, KS Hegde Medical Academy, Mangalore, India

出版信息

BMJ Case Rep. 2021 Apr 12;14(4):e240180. doi: 10.1136/bcr-2020-240180.

Abstract

Mucormycosis is a rare infection caused by Mucorales fungi belonging to Zygomycetes class. It can present with spectrum of symptoms and signs based of organ involvement. Common forms of mucormycosis includes rhinocerebral, cutaneous, gastrointestinal, pulmonary, disseminated and miscellaneous forms involving bones, breast, kidney and central nervous system. Pulmonary mucormycosis usually present with fever, cough, haemoptysis and is usually seen in immunocompromised patients like patients with diabetes or leukaemia, or those on chemotherapy or immunosuppressive therapy and rare in immunocompetent patients (6.25% of cases). Pulmonary mucormycosis can be diagnosed by radiological imaging studies, bronchoalveolar lavage (BAL) and histopathological evaluation of biopsy of the lesion; however, the gold standard is a positive fungal culture. Here, we describe two cases of pulmonary mucormycosis diagnosed by BAL in an immunocompetent patient.

摘要

毛霉病是一种由属于接合菌纲的毛霉目真菌引起的罕见感染。它可根据受累器官出现一系列症状和体征。毛霉病的常见形式包括鼻脑型、皮肤型、胃肠道型、肺型、播散型以及累及骨骼、乳腺、肾脏和中枢神经系统的其他类型。肺毛霉病通常表现为发热、咳嗽、咯血,常见于免疫功能低下的患者,如糖尿病或白血病患者,或接受化疗或免疫抑制治疗的患者,在免疫功能正常的患者中较为罕见(占病例的6.25%)。肺毛霉病可通过放射影像学检查、支气管肺泡灌洗(BAL)和病变活检的组织病理学评估来诊断;然而,金标准是真菌培养阳性。在此,我们描述了两例在免疫功能正常的患者中通过BAL诊断为肺毛霉病的病例。

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本文引用的文献

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Disease Entities in Mucormycosis.毛霉病中的疾病实体
J Fungi (Basel). 2019 Mar 14;5(1):23. doi: 10.3390/jof5010023.
3
Pulmonary mucormycosis mimicking an endobronchial mass.酷似支气管内肿物的肺毛霉菌病
Asian Cardiovasc Thorac Ann. 2018 Mar;26(3):242-244. doi: 10.1177/0218492318760711. Epub 2018 Feb 15.
4
Diagnosis and treatment of pulmonary mucormycosis: A case report.肺毛霉菌病的诊断与治疗:一例报告
Exp Ther Med. 2017 Oct;14(4):3788-3791. doi: 10.3892/etm.2017.4986. Epub 2017 Aug 22.

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