ABSTRACT
In retrospective multicenter study from years 2007-2017, we evaluated 59 oncohematological patients with mucormycosis and 541 with invasive aspergillosis (IA). Mucormycosis developed more often in children and adolescents (P = .001), as well as after the emergence of graft versus host disease (P = .0001). Patients with mucormycosis had more severe neutropenia (88% vs 82%), the median duration was 30 versus 14 days (P = .0001) and lymphocytopenia (77% vs 65%), with a median duration (25 vs 14 days, P = .001) as compared to patients with IA. The lung infection was less frequent in patients with mucormycosis than in IA patients (73% vs 97%, P = .02), but more frequent was involvement of 2 or more organs (42% vs 8%, P = .001) and involvement of paranasal sinuses (15% vs 6%, P = .04). Typical clinical features of mucormycosis were localized pain syndrome (53% vs 5%, P = .0001), hemoptysis (32% vs 6%, P = .001), pleural effusion on lung CT scan (53% vs 7%, P = .003), lesions with destruction (38% vs 8%, P = .0001), and a "reverse halo" sign (17% vs 3%). The overall 12-week survival was significantly lower in patients with mucormycosis than for IA patients (49% vs 81%, P = .0001). In both groups unfavorable prognosis factors were ≥2 organs involvement (P = .0009), and concomitant bacterial or viral infection (P = .001, P = .008, respectively). In mucormycosis patients favorable prognosis factor was remission of underlying disease (P = .006).
Subject(s)
Aspergillosis/pathology , Hematologic Neoplasms/complications , Mucormycosis/pathology , Aspergillosis/mortality , Humans , Mucormycosis/mortality , Retrospective Studies , Survival AnalysisABSTRACT
The incidence and prevalence of fungal infections in Russia is unknown. We estimated the burden of fungal infections in Russia according to the methodology of the LIFE program (www.LIFE-worldwide.org). The total number of patients with serious and chronic mycoses in Russia in 2011 was three million. Most of these patients (2,607,494) had superficial fungal infections (recurrent vulvovaginal candidiasis, oral and oesophageal candidiasis with HIV infection and tinea capitis). Invasive and chronic fungal infections (invasive candidiasis, invasive and chronic aspergillosis, cryptococcal meningitis, mucormycosis and Pneumocystis pneumonia) affected 69,331 patients. The total number of adults with allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitisation was 406,082.
Subject(s)
Mycoses/epidemiology , AIDS-Related Opportunistic Infections/epidemiology , Adult , Aspergillosis/epidemiology , Aspergillosis/microbiology , Aspergillosis, Allergic Bronchopulmonary/epidemiology , Aspergillosis, Allergic Bronchopulmonary/microbiology , Candidiasis/epidemiology , Candidiasis/microbiology , Candidiasis, Vulvovaginal/epidemiology , Candidiasis, Vulvovaginal/microbiology , Cost of Illness , Female , HIV Infections/epidemiology , HIV Infections/microbiology , Humans , Incidence , Male , Meningitis, Cryptococcal/epidemiology , Meningitis, Cryptococcal/microbiology , Mucormycosis/epidemiology , Mucormycosis/microbiology , Mycoses/complications , Mycoses/microbiology , Pneumonia, Pneumocystis/epidemiology , Pneumonia, Pneumocystis/microbiology , Prevalence , Russia/epidemiology , Tinea Capitis/epidemiology , Tinea Capitis/microbiologyABSTRACT
Thirty four patients with mucormycosis in 10 hospitals of St. Petersburg were observed in 2004-2013. The most frequent underlying diseases of mucormycosis were acute leukoses (64%). In 100% of the patients mucormycosis developed as a nosocomial infection. The risk factors, etiology, basic clinical signs and strategy in the treatment of mucormycosis were analyzed.
