PULMONARY MUCORMYCOSIS - RESULTS OF MEDICAL AND SURGICAL THERAPY

Mucormycosis is an opportunistic fungal infection that commonly begins by invading the respiratory tract. The purpose of the present study w as to define the clinical presentation of pulmonary mucormycosis and t o evaluate current treatment regimens. Thirty patients treated at our institution and 225 cases reported in the literature were reviewed. Fo r the combined groups, the mean age at presentation was 41 +/- 21 year s and associated medical conditions included leukemia or lymphoma (37% ), diabetes mellitus (32%), chronic renal failure (18%), history of or gan transplantation (7.6%), or a known solid tumor (5.6%). The in-hosp ital mortality was 65% for patients with isolated pulmonary mucormycos is, 96% for those with disseminated disease, and 80% overall. The mort ality in patients treated surgically was 11%, significantly lower than the 68% mortality in those treated medically (p = 0.0004). The most c ommon causes of death were fungal sepsis (42%), respiratory insufficie ncy (27%), and hemoptysis (13%). Pulmonary mucormycosis has a high mor tality; however, antifungal agents appear to improve survival. In addi tion, surgical resection may provide additional benefit to patients wi th pulmonary mucormycosis confined to one lung.