Wan Junjun, Liu Teng, Li Fang, Xu Shaohua
Department of Respiratory Medicine, the Second Hospital of Shandong University, Jinan, China.
Department of Ultrasound, Qilu Hospital of Shandong University, Jinan, China.
PLoS One. 2025 May 16;20(5):e0323624. doi: 10.1371/journal.pone.0323624. eCollection 2025.
Pulmonary mucormycosis is a rare and often fatal fungal infection. Identifying high-risk factors for pulmonary mucormycosis holds the potential to improve patient outcomes. This study aimed to identify the clinical characteristics and risk factors associated with pulmonary mucormycosis outcomes in a Chinese cohort.
A retrospective analysis was conducted on 37 patients diagnosed with pulmonary mucormycosis, focusing on clinical records, laboratory findings, and computed tomography (CT) imaging. Diagnosis was primarily based on histopathology or next-generation sequencing.
The median age of the patients was 55 years, and the most common underlying conditions were hematological malignancies, diabetes, and organ transplantation. Imaging frequently revealed bilateral lung involvement with ground-glass opacities and nodular lesions. The overall mortality rate was 29.7%, with significant risk factors for 90-day mortality including hypertension (Hazard Ratio [HR] = 3.36, 95% Confidence Interval [CI] = 1.01-11.12, P = 0.048), organ transplantation (HR = 4.93, 95% CI = 1.48-16.4, P = 0.009), and immunosuppression (HR = 8.83, 95% CI = 1.13-69.14, P = 0.038).
Early suspicion and timely diagnostic measures, such as biopsy or metagenomic sequencing, are crucial for improving patient outcomes. These findings underscore the importance of recognizing and managing pulmonary mucormycosis in high-risk populations.
肺毛霉病是一种罕见且往往致命的真菌感染。识别肺毛霉病的高危因素有可能改善患者预后。本研究旨在确定中国队列中与肺毛霉病预后相关的临床特征和危险因素。
对37例诊断为肺毛霉病的患者进行回顾性分析，重点关注临床记录、实验室检查结果和计算机断层扫描（CT）影像。诊断主要基于组织病理学或二代测序。
患者的中位年龄为55岁，最常见的基础疾病是血液系统恶性肿瘤、糖尿病和器官移植。影像学检查常显示双侧肺部受累，伴有磨玻璃影和结节性病变。总死亡率为29.7%，90天死亡率的显著危险因素包括高血压（风险比[HR]=3.36，95%置信区间[CI]=1.01-11.12，P=0.048）、器官移植（HR=4.93，95%CI=1.48-16.4，P=0.009）和免疫抑制（HR=8.83，95%CI=1.13-69.14，P=0.038）。
早期怀疑和及时的诊断措施，如活检或宏基因组测序，对改善患者预后至关重要。这些发现强调了在高危人群中识别和管理肺毛霉病的重要性。
