Korean J Crit Care Med.  2017 May;32(2):205-210. 10.4266/kjccm.2017.00150.

The Role of Transbronchial Lung Biopsy in Diagnosing Pulmonary Mucormycosis in a Critical Care Unit

• Hong Y
• Park J

• KMID: 2384046
• DOI: http://doi.org/10.4266/kjccm.2017.00150

Abstract

BACKGROUND
Pulmonary mucormycosis (PM) is an emerging infectious disease and a life-threatening infection with high mortality. The clinical outcomes of PM have not improved significantly over the last decade because early diagnosis of PM is difficult and antifungal agents show limited activity. We evaluated the clinical manifestations of PM in a Korean tertiary hospital and identified the role of transbronchial lung biopsy (TBLB) in diagnosing PM in patients admitted to an intensive care unit.
METHODS
The medical records of adult patients (aged 16 years and older) who met the criteria for proven or probable PM in a Korean tertiary hospital were retrospectively reviewed from January 2003 to December 2013. The clinical features, computed tomographic findings, diagnostic methods, treatment, and outcomes in patients with PM were evaluated.
RESULTS
Of the nine patients, four were male. The median age was 64 years (range, 12 to 73 years). PM was proven and probable in seven and two cases, respectively. Computed tomography findings of PM were unilateral involvement in eight cases (89%), consolidation in eight (89%), ground glass opacity in four (44%), and reverse halo sign in one (11%). Six of nine cases (67%) were diagnosed as PM from TBLB via portable bronchoscopy. There were no complications after TBLB. Mortality rate was 56% (five of nine cases).
CONCLUSIONS
TBLB can be an easy and useful technique for diagnosing PM in the intensive care unit.

Keyword

biopsy; bronchoscopy; intensive care units; mucormycosis

MeSH Terms

Adult
Antifungal Agents
Biopsy*
Bronchoscopy
Communicable Diseases, Emerging
Critical Care*
Early Diagnosis
Glass
Humans
Intensive Care Units
Lung*
Male
Medical Records
Mortality
Mucormycosis*
Retrospective Studies
Tertiary Care Centers
Antifungal Agents

Reference

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