| Objective:To find out the constitution of pathogen, underlying diseases, clinical features, imaging features, management and prognosis of pulmonary mycosis. Analysis of pulmonary aspergillosis and pulmonary candidiasis of the underlying diseases, symptoms, signs, imaging features, prognosis whether have the statistical difference.Methods:A retrospective survey of all inpatient medical records, in Shandong Provincial Hospital, from January 1999 to December 2008 had been done. Data of pathogen, underlying diseases, clinical features, imaging features, management and prognosis were retrospectively reviewed. Case selection criterion referenced "Diagnosis and treatment of pulmonary mycosis expert consensus" by Chinese Society of Respiratory Diseases, in 2007.Summing up the constitution of pathogen, underlying diseases, clinical manifestations, imaging characteristics, treatment and prognosis. Pulmonary aspergillosis and pulmonary candidiasis group are compared using the Chi-square test. Testing standards to takeα= 0.05, with P<0.05 as statistically significant difference.Results:1. Of the 57 cases,22 (38.60%) were pulmonary aspergillosis,12 (21.06%) were pulmonary candidiasis,of which Candida albicans in 10 patients (17.55%), Candida glabrata in 1 case (1.75%), Candida parapsilosis 1 cases (1.75%). Saccharomyces cerevisiae in 1 case (1.75%), Fusarium in 1 case (1.75%),1 case of histoplasmosis (1.75%), cryptococcosis in 1 case (1.75%), Pneumocystis carinii in 1 case(1.75%). Unclassified fungi in 18 cases (31.58%).2.Of the 57 cases,45 cases (78.94%) into underlying diseases, which combined structural lung disease in 16 cases (28.07%), malignancy in 13 cases (22.80%), severe trauma or after major surgery in 7 cases (12.28%), tuberculosis in 6 cases (10.52%), diabetes mellitus in 4 cases (7.01%), chronic obstructive pulmonary disease, coronary heart disease, cerebrovascular disease, putting tube of 3 cases respectively (5.26%), using of antibiotics more than 7 days in 2 cases (3.50%), congenital heart disease, renal failure, heart failure, lung abscess, bronchial asthma, long-term application of immunosuppressive agents, hormones and were each 1 case (1.75%).15 (26.31%) patients have two or more underlying diseases or risk factors.12 cases without underlying diseases (21.05%).3. The main symptoms are fever in 38 cases (66.66%), chills in 4 cases (7.01%), cough 45 cases (78.94%), expectoration 36 cases (63.15%), chest distress in 15 cases (26.31%), hemoptysis in 29 cases (50.87%), chest pain in 14 cases (24.56%). Dry rales were found in 15 cases (26.31%), moist rales in 22 cases (38.60%), pleural effusion in 19 patients (33.33%), and cyanosis in 2 cases (35.08%).4. Chest imaging manifestations of masses in 15 cases (26.31%), nodule lesions in 8 patients (14.03%), ground-glass infiltration shadow in 20 cases (35.08%), cavity in 15 cases (26.31%), Sign the ball inside the cave in 4 cases(7.01%), air semi lunar sign in 7 cases (12.28%), consolidation in 2 cases (3.51%)5. During the 57 cases of pulmonary fungal patients,23 cases with surgical removal of lesions (40.35%),34 cases have been used antifungal drug therapy (59.65%), fluconazole treatment of 18 cases (31.58%), and itraconazole treatment of 16 cases (28.07%). Cured 28 cases (49.12%), improved in 19 cases (33.33%), and invalid in 2 cases (3.51%), deterioration in 4 cases (7.02%), and death in 4 cases (7.02%).Conclusion:1. Pulmonary fungal disease with pulmonary aspergillosis is more common (38.60%), followed by pulmonary candidiasis (21.06%).2. Incidence of underlying diseases in Pulmonary aspergillosis is 81.82%, while in pulmonary candidiasis is 83.33%, the difference was not statistically significant.3. The incidence of hemoptysis in pulmonary aspergillosis (59.09%) is higher than pulmonary candidiasis (16.67%), the difference was statistically significant (P<0.05), other symptoms have no statistical difference. The incidence of dry rales in pulmonary aspergillosis (13.64%) is lower than pulmonary candidiasis (58.33%), the difference was statistically significant (P<0.05). The incidence of moist rales in Pulmonary aspergillosis (22.73%) is lower than pulmonary candidiasis (83.33%), the difference was statistically significant (P<0.05), other signs have no statistical difference.4. Cavity formation rate in pulmonary aspergillosis (50%) was significantly higher than pulmonary candidiasis (8.33%), the difference was statistically significant (P <0.05). The formation of ground-glass-like infiltration rate in pulmonary aspergillosis (18.18%) was significantly lower than pulmonary candidiasis (75.0%), the difference was statistically significant (P<0.05), the other imaging had no statistical difference.5. Surgical therapy and antifungal therapy are effective in treatment. Cure and improvement rate of pulmonary mycosis is82.45%. Cure and improvement rate of pulmonary aspergillosis group is 90.90%, while pulmonary candidiasis group is 66.67%. The difference was not statistically significant.
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