Yu-Hong Li1, Peng Sun2, Jian-Chao Guo2. 1. Department of Endocrinology, The Second Hospital of Tianjin Medical University, Tianjin, China. liyuhong2210@163.com. 2. Department of Endocrinology, The Second Hospital of Tianjin Medical University, Tianjin, China.
Abstract
OBJECTIVE: To improve the understanding of diabetic combined pulmonary mucormycosis. METHODS AND RESULTS: The clinical data of twelve patients diagnosed as diabetic combined pulmonary mucormycosis were analyzed by the clinical manifestations, imaging features, diagnosis, treatment and prognosis of this disease. Patients from January 1999 to June 2015 in our hospital had poor blood glucose control and varying degrees of diabetic chronic complications with an on average of diabetes 8.6 ± 3.5 years. The clinical symptoms of diabetic combined pulmonary mucormycosis included different degrees of fever, cough, sputum and dyspnea. The numbers of white blood cells and neutrophils were significantly elevated in patients, and Mucor had been checked in sputum culture for three times. In addition, although the liver and kidney functions were normal, the patients had hypoxemia and decreased diffusion capacity, lung capacity and carbon dioxide binding force. Imaging manifestations revealed small patchy shadows with nodular shadows and pneumonia in the lung of the patients. Twelve patients took oral hypoglycemic drugs for improving glucose combined with subcutaneous injection of insulin. One patient with intravenous injection of fluconazole was died of respiratory failure at 1 week. There were two of seven cases with amphotericin B liposome died of haemoptysis and respiratory failure, respectively, and the other five were cured. Moreover, four cases who took more than two drugs were cured. CONCLUSION: Diabetic with pulmonary mucormycosis is a rare but fatal fungal infection disease. Diagnosis and treatment early are essential to improve the prognosis of the patients.
OBJECTIVE: To improve the understanding of diabetic combined pulmonary mucormycosis. METHODS AND RESULTS: The clinical data of twelve patients diagnosed as diabetic combined pulmonary mucormycosis were analyzed by the clinical manifestations, imaging features, diagnosis, treatment and prognosis of this disease. Patients from January 1999 to June 2015 in our hospital had poor blood glucose control and varying degrees of diabetic chronic complications with an on average of diabetes 8.6 ± 3.5 years. The clinical symptoms of diabetic combined pulmonary mucormycosis included different degrees of fever, cough, sputum and dyspnea. The numbers of white blood cells and neutrophils were significantly elevated in patients, and Mucor had been checked in sputum culture for three times. In addition, although the liver and kidney functions were normal, the patients had hypoxemia and decreased diffusion capacity, lung capacity and carbon dioxide binding force. Imaging manifestations revealed small patchy shadows with nodular shadows and pneumonia in the lung of the patients. Twelve patients took oral hypoglycemic drugs for improving glucose combined with subcutaneous injection of insulin. One patient with intravenous injection of fluconazole was died of respiratory failure at 1 week. There were two of seven cases with amphotericin B liposome died of haemoptysis and respiratory failure, respectively, and the other five were cured. Moreover, four cases who took more than two drugs were cured. CONCLUSION:Diabetic with pulmonary mucormycosis is a rare but fatal fungal infection disease. Diagnosis and treatment early are essential to improve the prognosis of the patients.
Authors: Thomas J Walsh; Maria N Gamaletsou; Michael R McGinnis; Randall T Hayden; Dimitrios P Kontoyiannis Journal: Clin Infect Dis Date: 2012-02 Impact factor: 9.079
Authors: Anna Skiada; Fanny Lanternier; Andreas H Groll; Livio Pagano; Stephan Zimmerli; Raoul Herbrecht; Olivier Lortholary; George L Petrikkos Journal: Haematologica Date: 2012-09-14 Impact factor: 9.941