全肺切除治療肺毛霉菌病合并肺膿腫一例并文獻復習_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

鄭華德 ,  魏曉陽 , 王海燕 , 文仲光

解放軍總醫院第八醫學中心呼吸與危重癥醫學科（北京 100091）;

Corresponding?author：

魏曉陽, Email: 289163121@qq.com

Keywords：

侵襲性支氣管肺毛霉菌病; 毛霉菌肺膿腫; 全肺切除術

DOI：

10.7507/1671-6205.202309051

Video：

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目的探討侵襲性支氣管肺毛霉菌病合并毛霉菌肺膿腫內科治療無效時外科手術的可行性。方法報告1例2022年在解放軍總醫院第八醫學中心住院的支氣管肺毛霉菌病合并毛霉菌肺膿腫患者內科治療及外科手術過程，并對外科手術在肺毛霉菌病治療中的有關文獻進行復習。結果患者男性，29歲，某藥廠排污廠房工人，既往患有糖尿病。因咳嗽，咳痰，咯血40余天，高熱5天入院。經支氣管鏡活檢診斷為左主支氣管毛霉菌病，積極內科治療無效時，行左全肺切除術，術后治愈出院。術后病理示支氣管肺毛霉菌病并左下肺毛霉菌肺膿腫。文獻復習顯示外科手術是支氣管肺毛霉菌病治療手段之一，但目前肺毛霉菌病手術治療多限于單純孤立病灶和肺葉切除術，全肺切除術罕見。未檢索到類似本例全肺切除治愈支氣管肺毛霉菌病，毛霉菌肺膿腫的報告。結論侵襲性支氣管肺毛霉菌病，合并毛霉菌肺膿腫在內科治療無效時，外科手術治療亦應值得考慮。

Citation： 鄭華德, 魏曉陽, 王海燕, 文仲光. 全肺切除治療肺毛霉菌病合并肺膿腫一例并文獻復習. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(11): 805-808. doi: 10.7507/1671-6205.202309051 Copy

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9.	Lin E, Moua T, Limper AH. Pulmonary mucormycosis: clinical features and outcomes. Infection, 2017, 45(4): 443-448.
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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.	楊翼萌, 方保民, 許小毛, 等. 肺毛霉病五例及國內46例臨床分析. 中華結核和呼吸雜志, 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. 劉又寧, 佘丹陽, 孫鐵英, 等. 中國1998年至2007年臨床確診的肺真菌病患者的多中心回顧性調查. 中華結核和呼吸雜志, 2011, 34(2): 86-90.
6. 楊政, 劉正印. 毛霉菌病的診斷和治療進展. 中華內科雜志, 2021, 60(11): 1013-1016.
7. 應琳, 周建英. 肺毛霉菌病的再認識. 國際呼吸雜志, 2013, 33(18): 1422-1424.
8. 中華醫學會呼吸病學分會感染學組, 中華結核和呼吸雜志編輯委員會. 肺真菌病診斷和治療專家共識. 中華結核和呼吸雜志, 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. 楊翼萌, 方保民, 許小毛, 等. 肺毛霉病五例及國內46例臨床分析. 中華結核和呼吸雜志, 2013, 36(8): 5.

Chinese Journal of Respiratory and Critical Care Medicine

全肺切除治療肺毛霉菌病合并肺膿腫一例并文獻復習

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