全肺切除治疗肺毛霉菌病合并肺脓肿一例并文献复习_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

郑华德 ,  魏晓阳 , 王海燕 , 文仲光

解放军总医院第八医学中心呼吸与危重症医学科（北京 100091）;

Corresponding author：

魏晓阳, Email: 289163121@qq.com

Keywords：

侵袭性支气管肺毛霉菌病; 毛霉菌肺脓肿; 全肺切除术

DOI：

10.7507/1671-6205.202309051

Video：

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目的探讨侵袭性支气管肺毛霉菌病合并毛霉菌肺脓肿内科治疗无效时外科手术的可行性。方法报告1例2022年在解放军总医院第八医学中心住院的支气管肺毛霉菌病合并毛霉菌肺脓肿患者内科治疗及外科手术过程，并对外科手术在肺毛霉菌病治疗中的有关文献进行复习。结果患者男性，29岁，某药厂排污厂房工人，既往患有糖尿病。因咳嗽，咳痰，咯血40余天，高热5天入院。经支气管镜活检诊断为左主支气管毛霉菌病，积极内科治疗无效时，行左全肺切除术，术后治愈出院。术后病理示支气管肺毛霉菌病并左下肺毛霉菌肺脓肿。文献复习显示外科手术是支气管肺毛霉菌病治疗手段之一，但目前肺毛霉菌病手术治疗多限于单纯孤立病灶和肺叶切除术，全肺切除术罕见。未检索到类似本例全肺切除治愈支气管肺毛霉菌病，毛霉菌肺脓肿的报告。结论侵袭性支气管肺毛霉菌病，合并毛霉菌肺脓肿在内科治疗无效时，外科手术治疗亦应值得考虑。

Citation： 郑华德, 魏晓阳, 王海燕, 文仲光. 全肺切除治疗肺毛霉菌病合并肺脓肿一例并文献复习. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(11): 805-808. doi: 10.7507/1671-6205.202309051 Copy

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2.	Prabhu RM, Patel R. Mucormycosis and entomophthoramycosis: a review of the clinical manifestations, diagnosis and treatment. Clin Microbiol Infect, 2004, 10 Suppl 1: 31-47.
3.	Afolayan O, Copeland H, Zaheer S, et al. Pulmonary mucormycosis treated with lobectomy. Ann Thorac Surg, 2017, 103(6): e531-e533.
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8.	中华医学会呼吸病学分会感染学组, 中华结核和呼吸杂志编辑委员会. 肺真菌病诊断和治疗专家共识. 中华结核和呼吸杂志, 2007, 30(11): 821-834.
9.	Lin E, Moua T, Limper AH. Pulmonary mucormycosis: clinical features and outcomes. Infection, 2017, 45(4): 443-448.
10.	Danion F, Aguilar C, Catherinot E, et al. Mucormycosis: new developments into a persistently devastating infection. Semin Respir Crit Care Med, 2015, 36(5): 692-705.
11.	Cornely OA, Alastruey-Izquierdo A, Arenz D, et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis, 2019, 19(12): e405-e421.
12.	Choi H, Lee H, Jeon K, et al. Factors affecting surgical resection and treatment outcomes in patients with pulmonary mucormycosis. J Thorac Dis, 2019, 11(3): 892-900.
13.	Roden MM, Zaoutis TE, Buchanan WL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis, 2005, 41(5): 634-653.
14.	Skiada A, Pagano L, Groll A, et al. Zygomycosis in Europe: analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on Zygomycosis between 2005 and 2007. Clin Microbiol Infect, 2011, 17(12): 1859-1867.
15.	Lee FY, Mossad SB, Adal KA. Pulmonary mucormycosis: the last 30 years. Arch Intern Med, 1999, 159(12): 1301-1309.
16.	Mills SEA, Yeldandi AV, Odell DD. Surgical treatment of multifocal pulmonary mucormycosis. Ann Thorac Surg, 2018, 106(2): e93-e95.
17.	杨翼萌, 方保民, 许小毛, 等. 肺毛霉病五例及国内46例临床分析. 中华结核和呼吸杂志, 2013, 36(8): 5.

1. Hamilos G, Samonis G, Kontoyiannis DP. Pulmonary mucormycosis. Semin Respir Crit Care Med, 2011, 32(6): 693-702.
2. Prabhu RM, Patel R. Mucormycosis and entomophthoramycosis: a review of the clinical manifestations, diagnosis and treatment. Clin Microbiol Infect, 2004, 10 Suppl 1: 31-47.
3. Afolayan O, Copeland H, Zaheer S, et al. Pulmonary mucormycosis treated with lobectomy. Ann Thorac Surg, 2017, 103(6): e531-e533.
4. Tedder M, Spratt JA, Anstadt MP, et al. Pulmonary mucormycosis: results of medical and surgical therapy. Ann Thorac Surg, 1994, 57(4): 1044-1050.
5. 刘又宁, 佘丹阳, 孙铁英, 等. 中国1998年至2007年临床确诊的肺真菌病患者的多中心回顾性调查. 中华结核和呼吸杂志, 2011, 34(2): 86-90.
6. 杨政, 刘正印. 毛霉菌病的诊断和治疗进展. 中华内科杂志, 2021, 60(11): 1013-1016.
7. 应琳, 周建英. 肺毛霉菌病的再认识. 国际呼吸杂志, 2013, 33(18): 1422-1424.
8. 中华医学会呼吸病学分会感染学组, 中华结核和呼吸杂志编辑委员会. 肺真菌病诊断和治疗专家共识. 中华结核和呼吸杂志, 2007, 30(11): 821-834.
9. Lin E, Moua T, Limper AH. Pulmonary mucormycosis: clinical features and outcomes. Infection, 2017, 45(4): 443-448.
10. Danion F, Aguilar C, Catherinot E, et al. Mucormycosis: new developments into a persistently devastating infection. Semin Respir Crit Care Med, 2015, 36(5): 692-705.
11. Cornely OA, Alastruey-Izquierdo A, Arenz D, et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis, 2019, 19(12): e405-e421.
12. Choi H, Lee H, Jeon K, et al. Factors affecting surgical resection and treatment outcomes in patients with pulmonary mucormycosis. J Thorac Dis, 2019, 11(3): 892-900.
13. Roden MM, Zaoutis TE, Buchanan WL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis, 2005, 41(5): 634-653.
14. Skiada A, Pagano L, Groll A, et al. Zygomycosis in Europe: analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on Zygomycosis between 2005 and 2007. Clin Microbiol Infect, 2011, 17(12): 1859-1867.
15. Lee FY, Mossad SB, Adal KA. Pulmonary mucormycosis: the last 30 years. Arch Intern Med, 1999, 159(12): 1301-1309.
16. Mills SEA, Yeldandi AV, Odell DD. Surgical treatment of multifocal pulmonary mucormycosis. Ann Thorac Surg, 2018, 106(2): e93-e95.
17. 杨翼萌, 方保民, 许小毛, 等. 肺毛霉病五例及国内46例临床分析. 中华结核和呼吸杂志, 2013, 36(8): 5.

Chinese Journal of Respiratory and Critical Care Medicine

全肺切除治疗肺毛霉菌病合并肺脓肿一例并文献复习

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