Retrospective Analysis On Diagnosis And Treatment Of Community Acquired Pulmonary Mycosis

Objective: To analyse clinical and etiologic feature, diagnosis and prognosis of community acquired pulmonary mycosis.Methods: Retrospectively analyse the clinical data of 23 patients who were diagnosed community acquired pulmonary mycosis between January 2006 and February 2007 in the Second Affiliated Hospital of Medical College, Zhejiang University, and evaluate their clinical manifestations, imageologic and etiologic features, diagnosis and treatment.Results: 10 cases of the 23 patients were diagnosed without underlying diseases, while the other 14 cases with underlying diseases contributing to immunodepression. The clinical manifestations of these patients were not specific,which usually were cough, expectoration and hemoptysis. Chest CT scan mostly indicated intrapulmonary cavities accompanied globular infiltrations. Definite microbiologic or pathologic evidence were found in 19 cases, and the other 4 cases were clinical diagnosed. 16 cases were treated effectively with operation or anti-fungus therapy(total efficacy 84.2 % ). Adverse reactions of amphotericin B were common in anti-fungus therapy.Conclusion: Because the clinical manifestations of the patients with community acquired pulmonary mycosis were not specific, imageologic characteristic of this disease should be well recognized. Repeated sputum culture and early invasive examination should be recommended in those suspected cases. It is important to choose a rational regimen according to states of the patients and characteristic of focuses.