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The Annals of Thoracic Surgery, Vol 57, 1044-1050, Copyright © 1994 by The Society of Thoracic Surgeons
M Tedder, JA Spratt, MP Anstadt, SS Hegde, SD Tedder and JE Lowe
Mucormycosis is an opportunistic fungal infection that commonly begins by
invading the respiratory tract. The purpose of the present study was to
define the clinical presentation of pulmonary mucormycosis and to evaluate
current treatment regimens. Thirty patients treated at our institution and
225 cases reported in the literature were reviewed. For the combined
groups, the mean age at presentation was 41 +/- 21 years and associated
medical conditions included leukemia or lymphoma (37%), diabetes mellitus
(32%), chronic renal failure (18%), history of organ transplantation
(7.6%), or a known solid tumor (5.6%). The in-hospital mortality was 65%
for patients with isolated pulmonary mucormycosis, 96% for those with
disseminated disease, and 80% overall. The mortality in patients treated
surgically was 11%, significantly lower than the 68% mortality in those
treated medically (p = 0.0004). The most common causes of death were fungal
sepsis (42%), respiratory insufficiency (27%), and hemoptysis (13%).
Pulmonary mucormycosis has a high mortality; however, antifungal agents
appear to improve survival. In addition, surgical resection may provide
additional benefit to patients with pulmonary mucormycosis confined to one
lung.
ARTICLES
Pulmonary mucormycosis: results of medical and surgical therapy
Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710.
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