Zhang Ruhui, Jin Ge, Zhan Yasheng, Shen Lisha, Yao Yake, Gao Qiqi, Yang Qing, Zhou Jianying, Zhou Hua
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Pathology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Med (Lausanne). 2022 Feb 24;9:831213. doi: 10.3389/fmed.2022.831213. eCollection 2022.
Mucormycosis is a rare and invasive fungal infection with high mortality. Cases of invasive pulmonary mucormycosis that involve allergic reactions such as allergic bronchopulmonary mycosis are rarely reported. Herein, we describe a case of invasive pulmonary mucormycosis overlapping with allergic diseases in a patient who presented with eosinophilia and high total plasma immunoglobulin E (IgE). The patient was successfully treated with systemic corticosteroids (initial dose of prednisolone approximately 0.5 mg/kg per day, total duration less than 3 months) combined with posaconazole antifungal therapy. The treatment resulted in recovery of peripheral-blood eosinophil count and total plasma IgE, and significant reduction in lung lesions. A subsequent lobectomy was performed. The findings in this case indicate that systemic corticosteroid therapy may contribute to the treatment of pulmonary mucormycosis combined with allergic factors.
毛霉病是一种罕见的侵袭性真菌感染,死亡率很高。侵袭性肺毛霉病合并过敏反应(如过敏性支气管肺真菌病)的病例鲜有报道。在此,我们描述了一例侵袭性肺毛霉病与过敏性疾病重叠的病例,该患者表现为嗜酸性粒细胞增多和血浆总免疫球蛋白E(IgE)升高。患者接受全身性糖皮质激素(初始剂量为泼尼松龙约0.5mg/kg/天,总疗程少于3个月)联合泊沙康唑抗真菌治疗后成功治愈。治疗使外周血嗜酸性粒细胞计数和血浆总IgE恢复正常,肺部病变显著减轻。随后进行了肺叶切除术。该病例的研究结果表明,全身性糖皮质激素治疗可能有助于治疗合并过敏因素的肺毛霉病。