Risk for Mortality after Surgical Intervention for Pulmonary Mucormycosis
Selina Juarez1, Alykhan Nagji2, Nirmal Veeramachaneni2, Sharon Ben-Or2.
1Prisma Health, Greenville, SC, USA, 2University of Kansas Medical Center, Kansas City, KS, USA.
Background: Mucormycosis is an angioinvasive fungal infection due to fungi of the order Mucorales. It is more prevalent in immunocompromised patients. Its prognosis is poor because of its highly invasive nature, low susceptibility to antifungal agents and requires a high index of suspicion by clinicians.
Methods: We performed a retrospective single institute study from 2014 to 2021 of patients who underwent surgical intervention for pulmonary mucormycosis..
Results: We were able to identify five patients that were diagnosed with and underwent surgical intervention for pulmonary mucormycosis. Mean age of 39.8±20.2. Risks factors identified included: diabetes, bone marrow transplant, and chronic steroids. Sixty percent of the patient were biologically male. Eighty percent of patients had hematological disease including AML (2), ALL (1), and IGA deficiency (1). Two of the five patients died of mucormycosis; one died from unrelated causes.
Conclusions: The overall prognosis of mucormycosis remains poor, especially in patients with hematological malignancies. One of the key steps in management of mucormycosis is the high index of suspicion. Patients with hematologic disease, multilobar disease, central airway disease, and require multiple surgical interventions tend to have a poorer prognosis. Larger multi-institutional reviews should be performed to identify risk factors for mortality.
|Predictive Factors for Mortality from Mucormycosis||Alive/DeceasedFrom other cause (n=3)||Deceased(n=2)|
|Bone Marrow Transplant||1||1|
|Time from CT to Antifungal start||26.67 + 25.5 days||2+ 2.83 days|
|Time from CT to OR||63.3 + 49.05 days||9.5 + 3.54|
|Multiple Surgical Interventions||0||2|
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