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从楔形肺切除术到全肺切除术的肺切除作为肺毛霉菌病的手术选择。

Lung resection from wedge to pneumonectomy as surgical options for pulmonary mucormycosis.

作者信息

Pohlman Alexander, Nizamuddin Mohammad, Albarillo Fritzie S, Abdelsattar Zaid M

机构信息

Department of Thoracic & CV Surgery, Loyola University Medical Center, Maywood, IL, United States.

Department of Surgery, University of Illinois College of Medicine, Chicago, IL, United States.

出版信息

J Surg Case Rep. 2024 Nov 25;2024(11):rjae753. doi: 10.1093/jscr/rjae753. eCollection 2024 Nov.

Abstract

Pulmonary mucormycosis (PM) is a rare and life-threatening condition, most prevalent in immunocompromised patients. Early signs and symptoms are often nonspecific. A high index of suspicion in at risk patients should prompt early infectious work-up, including bronchoscopy, followed by aggressive antifungal therapy and early surgical resection when indicated. We demonstrate these core tenants of diagnosis and management of PM via two patient presentations, the first involving a kidney transplant recipient who presented with a mild cough, found to have a lung lesion with rapid growth over a few weeks; the second involving a patient with acute lymphoblastic leukemia who presented with hemoptysis and imaging revealing a 5 cm perihilar mass obliterating the left pulmonary artery. Both patients were managed with aggressive surgical therapy.

摘要

肺毛霉病(PM)是一种罕见且危及生命的疾病,在免疫功能低下的患者中最为常见。早期症状和体征往往不具特异性。对高危患者保持高度怀疑指数应促使尽早进行感染方面的检查,包括支气管镜检查,随后在有指征时进行积极的抗真菌治疗和早期手术切除。我们通过两个病例展示了PM诊断和管理的这些核心要点,第一个病例涉及一名肾移植受者,该患者出现轻度咳嗽,经检查发现肺部有一个在几周内迅速生长的病变;第二个病例涉及一名急性淋巴细胞白血病患者,该患者出现咯血,影像学检查显示一个5厘米的肺门周围肿块,阻塞了左肺动脉。两名患者均接受了积极的手术治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41f9/11588314/62ce68658df8/rjae753f1.jpg

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