Objective To investigate the clinical manifestation and histopathologic changes of the fungal necrotizing retinochoroiditis. Methods Collecting 7 cases of fungal retinochoroiditis with severe immunodepression and loss of visual acuity.Seven removed eyeballs were stained with HE,PAS and silver methenamine,and observed by light microscopy,and in addition,2 of them examined by electron microscopy.Also fungal cultures of blood and affected tissues were performed. Results The chief clinical macnifestation included ciliary injection of conjunctiva,opaque aqueous fluid and vitreous and diffuse hemorrhage and greyt white opacity with retinal detachment in severe cases.Pathologic changes included hemorrhage in the retina,chorioretinal tissue necrosis,hyphae in the blood vessels,affected tissue and vitreous.Fungal culture of blood was positive in three cases.Culture of affected tissues was positive in all cases. Conclusions Eedogenous fungal infection of choroid and retina may be due to the severe immunodepression of the sufferers and usually causes chorioretinal tissue destruction and blind. (Chin J Ocul Fundus Dis, 1999, 15: 235-237)
Objective To improve the knowledge of pulmonary mucormycosis through summarizing the clinical features and treatment of the disease. Methods A retrospective analysis was conducted on two cases of mucormycosis. The literature review was carried out with " pulmonary mucormycosis” as the research terms respectively in CNKI and Pubmed database. Search time ranged from January 2000 to June 2016. Results The first case was a 61-year-old male patient complained of cough, expectoration and dyspnea for 5 days. Chest computerized tomography (CT) showed lung nodules in the right upper lobe and bronchial cut off sign of apical bronchus. The patient received bronchoscopic examination and pathological findings indicated mucormycosis. Amphotericin B was recommended for the treatment. The patient recovered after treatment and was discharged. The second case was a 44-year-old female patient admitted to our hospital due to cough accompanied with expectoration and fever for over 10 days. Chest CT scan showed multiple double-pulmonary circular nodules and cavities with different sizes and clear boundary. The maximum cavity diameter was about 1.8cm, and the density of soft tissue was found in the part of the cavity. The patient received CT-guided percutaneous lung biopsy and pathological findings indicated fungal hyphae which was accorded with mucor infection. The patient received amphotericin B, voriconazole and posaconazole treatment, but with bad curative effect. She gave up therapy and died one week later after discharged. A total of 6 literatures were reviewed in above-mentioned databases. The clinical manifestations were nonspecific and the patients were likely to accompany with other diseases. The duration from the onset of symptoms to exact diagnosis was 37.5 days. Chest CT scan and pathological examination played important roles in the diagnosis of mucormycosis. Proper antifungal treatment could improve the prognosis. Conclusions Mucormycosis is a rare invasive fungal disease with high mortality. The clinical manifestations are nonspecific. Early diagnosis and appropriate treatment contribute to better prognosis.
The epidemiology of respiratory viruses in China are complex and diverse, and viral infections are prone to secondary mucormycosis, posing serious challenges to clinical and public health. The consensu is formulated by domestic experts organized by the Center of Infectious Diseases of West China Hospital of Sichuan University, aiming to identify high-risk groups of respiratory virus infection secondary to mucormycosis, and put forward systematic prevention suggestions. The content covers four aspects: education and training, personal protection, early diagnosis and treatment, and infection control, forming 11 specific recommended measures. It also points out the prevention measures that are still controversial or lack evidence and future research directions, in order to improve the understanding of clinical medical staff, optimize prevention and control strategies, and reduce the risk of secondary mucormycosis.
ObjectiveTo analyze the clinical characteristics, prognosis and predisposing factors of coronavirus disease 2019 (COVID-19) associated pulmonary mucormycosis (CAPM), so as to improve people's understanding of the disease.MethodsFrom from September 1, 2021 to July 31, 2024, 11 patients with CAPM who were hospitalized in Beijing Chaoyang Hospital affiliated to Capital Medical University were retrospectively collected, and 22 patients with non-CAPM were included after matching according to the ratio of 1:2. The clinical manifestations, laboratory examinations, imaging features, tracheoscopy, treatment and prognosis of the two groups were analyzed. ResultsThe average age of patients in CAPM group was 59.5 ± 10.6 years, with 81.8% of males; diabetes mellitus (90.9%) was the most common complication. In CAPM group, the median time after the occurrence of mucor after COVID-19 was 13.0 (10.0, 24.0) days. The utilization rate of glucocorticoids in the CAPM group was 63.6% (7/11), which was significantly higher than that in non-CAPM group (13.6% (3/22)), and the difference between the groups was statistically significant (P=0.006). The C-reactive protein level in CAPM group was significantly higher at 93.90 (75.00, 129.00) mg/L than that in non-CAPM group at 26.10 (4.83,114.03) mg/L, with a statistically significant difference (P=0.040). The CD4+T lymphocyte counts and B lymphocyte counts in CAPM group were 223.00 (66.75,336.75)/µL and 32.00 (21.75,55.25)/µL, respectively, which were significantly lower than those in the non-CAPM group (394.00 (206.00, 610.00)/µL and 112.50 (56.00,159.25)/µL, with statistical differences between the groups (P=0.040, P=0.040). In terms of imaging, the main imaging findings were the involvement of multiple lobes in both groups. 63.6% (7/11) of patients with pulmonary aspergillosis in CAPM group were significantly higher than those(4/22,18.2%) in non-CAPM group (P=0.017). The incidence of dyspnea in CAPM group was significantly higher than that in non-CAPM group (90.9% vs. 50.0%, 0.027%).ConclusionThe proportion of glucocorticoid use and the proportion of pulmonary aspergillosis in CAPM group are significantly higher, and they are in a more serious state of immunosuppression. Once combined with pulmonary aspergillus , the mortality rate is higher.