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多种诊断方法用于毛霉病:一项回顾性病例系列研究。

Multiple diagnostic methods for mucormycosis: A retrospective case series.

机构信息

Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

出版信息

J Clin Lab Anal. 2022 Aug;36(8):e24588. doi: 10.1002/jcla.24588. Epub 2022 Jul 6.

Abstract

BACKGROUND

Mucormycosis is a rare invasive fungal disease with high mortality. Early diagnosis and targeted drugs are crucial to improving clinical outcomes.

METHODS

We searched the electronic hospital database of the First Affiliated Hospital of Zhejiang University School of Medicine for adult patients with mucormycosis between 2000 and 2021. Demographic, clinical, treatment, and outcome data were collected and compared with the data in the relevant literature.

RESULTS

Eleven cases of mucormycosis-four of multisite infection, one of skin infection, five of lung infection, and one of gastrointestinal infection-were found and analyzed. The patients were diagnosed mainly based on pathological and histological findings, and three patients had metagenomic next-generation sequencing findings. Delayed diagnosis (i.e., diagnosis >7 days after patient admission or >30 days after onset of symptoms) results in poor prognosis compared with early diagnosis.

CONCLUSIONS

Improving awareness and shortening diagnosis time may improve the prognosis of mucormycosis. If mucormycosis is suspected, appropriate samples should be collected as soon as possible and submitted for biopsy, culture, or mNGS to confirm the diagnosis.

摘要

背景

毛霉菌病是一种罕见的侵袭性真菌感染,死亡率高。早期诊断和靶向药物治疗对于改善临床结局至关重要。

方法

我们检索了浙江大学医学院附属第一医院 2000 年至 2021 年期间成人毛霉菌病患者的电子医院数据库。收集了人口统计学、临床、治疗和结局数据,并与相关文献中的数据进行了比较。

结果

共发现并分析了 11 例毛霉菌病病例——4 例多部位感染,1 例皮肤感染,5 例肺部感染,1 例胃肠道感染。患者主要基于病理和组织学发现进行诊断,3 例患者有宏基因组下一代测序发现。与早期诊断相比,延迟诊断(即患者入院后>7 天或症状出现后>30 天诊断)会导致预后不良。

结论

提高认识和缩短诊断时间可能会改善毛霉菌病的预后。如果怀疑毛霉菌病,应尽快采集适当的样本进行活检、培养或 mNGS 以确认诊断。

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