Two Cases Report Of Invasive Pulmonary Fungal Disease Without Obvious Host Factor And Review Of The Literature

Objective:To raise the recognition of invasive pulmonary fungal disease (IPFD) in patients without obvious host factor, especially in those with apparent inhalation history.Methods:We reported two cases of invasive pulmonary fungal disease in two patients without host factor. Domestic and abroad databases have been searched to find similar kind of disease. At the same time, the common predisposition, clinical characteristics, chest CT imaging, the process of the cases, diagnosis and treatment ways have been retrospectively reviewed.Results:The diagnosis of IPFD is relied on host fators, clinical manifestations, mycological and histological evidence. The first case is diagnosed as proven IPFD with histological evidence. The second one can’t match the proven criteria as its diagnosis mainly relies on induced sputum, fever poor action to antibiotics, positive result of GM test and chest CT imaging. From articles about patients without host factor, we conclude basic diseases, or suffering from direct inhalation may have the risk of invasive fungal disease. IPFD in patients without host factor can’t be recognized in the early time, and can’t treat early. Clinical manifestations are lack of special characteristics.Conclusions:Patients without host factors should not be ignored in the diagnosis of IPFD, especially for those having an inhalation history. However clinical and imaging manifestations are not special for those patients. Most cases are misdiagnosed at the early stage. So far, chest CT, airway secrection smear. GM and G test and PCR methods are involved in the early diagnosis way. Limitations exist in every methods, so the early diagnosis of IPFD has an challenge.