Contrasts between mucormycosis and aspergillosis in oncohematological patients
| Autor: | Nikolay Klimko, O. Uspenskaya, M. Popova, T. Shneyder, T. Bogomolova, A. Volkova, Boris V. Afanasyev, S. Ignatyeva, Ludmila S. Zubarovskaya, O. V. Shadrivova, S. N. Khostelidi |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Pleural effusion Aspergillosis Gastroenterology 03 medical and health sciences Internal medicine medicine Humans Mucormycosis 030304 developmental biology Retrospective Studies 0303 health sciences Acute leukemia 030306 microbiology business.industry General Medicine medicine.disease Survival Analysis Infectious Diseases Graft-versus-host disease Paranasal sinuses medicine.anatomical_structure Concomitant Hematologic Neoplasms Lymphocytopenia business |
| Zdroj: | Medical mycology. 57(Supplement_2) |
| ISSN: | 1460-2709 |
| Popis: | In retrospective multicenter study from years 2007-2017, we evaluated 59 oncohematological patients with mucormycosis and 541 with invasive aspergillosis (IA). Mucormycosis developed more often in children and adolescents (P = .001), as well as after the emergence of graft versus host disease (P = .0001). Patients with mucormycosis had more severe neutropenia (88% vs 82%), the median duration was 30 versus 14 days (P = .0001) and lymphocytopenia (77% vs 65%), with a median duration (25 vs 14 days, P = .001) as compared to patients with IA. The lung infection was less frequent in patients with mucormycosis than in IA patients (73% vs 97%, P = .02), but more frequent was involvement of 2 or more organs (42% vs 8%, P = .001) and involvement of paranasal sinuses (15% vs 6%, P = .04). Typical clinical features of mucormycosis were localized pain syndrome (53% vs 5%, P = .0001), hemoptysis (32% vs 6%, P = .001), pleural effusion on lung CT scan (53% vs 7%, P = .003), lesions with destruction (38% vs 8%, P = .0001), and a "reverse halo" sign (17% vs 3%). The overall 12-week survival was significantly lower in patients with mucormycosis than for IA patients (49% vs 81%, P = .0001). In both groups unfavorable prognosis factors were ≥2 organs involvement (P = .0009), and concomitant bacterial or viral infection (P = .001, P = .008, respectively). In mucormycosis patients favorable prognosis factor was remission of underlying disease (P = .006). |
| Databáze: | OpenAIRE |
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