Related Experiment Video
Updated: Jan 25, 2026
Microscopic Cyst Resection for the Treatment of Patients Diagnosed with Epididymal Cyst
Published on: March 31, 2023
Factors affecting surgical resection and treatment outcomes in patients with pulmonary mucormycosis
Hayoung Choi1, Hyun Lee2, Kyeongman Jeon3
1Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
Background:
Surgical resection is the cornerstone treatment for pulmonary mucormycosis, a lethal fungal infection. It is unclear why some patients do not receive surgery, and the natural courses of these patients have not been well evaluated.
Methods:
A retrospective review was performed using the medical records of 20 patients with pathologically-confirmed pulmonary mucormycosis. We evaluated the reasons for not receiving surgery and compared treatment outcomes between patients who did and did not undergo surgery.
Results:
Overall survival rate was 50%. Nine of 11 (82%) patients who underwent surgery survived; however, only 1 of 9 (11%) patients who did not undergo surgery survived. Reasons for not receiving surgery were death shortly after diagnosis (n=1), altered mental state (n=1), refractory underlying disease (n=3), and refusal by patient due to concern of operative risk (n=4). Patients who did not undergo surgery were more likely to be older (P=0.018), have a longer duration of steroid use (P=0.021), higher lactate dehydrogenase level (P=0.039), higher sequential organ failure assessment (SOFA) score (P=0.035), and higher rate of cytomegalovirus (CMV) infection (P=0.020) than those did receive surgery. Surgery was the only favorable survival factor in multivariable analyses (adjusted odds ratio for survival =15.45; P=0.029).
Conclusions:
The main reasons for not undergoing surgery in patients with pulmonary mucormycosis were the gravity of underlying diseases and concerns for operative risk. Although overall survival rate was poor, it was significantly higher in patients who received pulmonary resection surgery. The decision to undergo lung resection is time-sensitive and essential in improving survival rate in patients suffering from pulmonary mucormycosis, despite perioperative risks.
Insights
Surgical resection significantly improves survival for pulmonary mucormycosis patients. Key reasons for not operating include severe illness and operative risk concerns, but timely lung resection is vital for better outcomes.
Area of Science:
- Pulmonology
- Infectious Diseases
- Surgical Oncology
Background:
- Pulmonary mucormycosis is a life-threatening fungal infection.
- Surgical resection is the primary treatment, but reasons for non-surgical management and outcomes are poorly understood.
Purpose of the Study:
- To investigate the reasons why some patients with pulmonary mucormycosis do not undergo surgery.
- To compare survival rates and outcomes between patients who did and did not receive surgical resection.
Main Methods:
- Retrospective review of medical records for 20 patients with pathologically confirmed pulmonary mucormycosis.
- Analysis of reasons for surgical exclusion and comparison of treatment outcomes based on surgical status.
Main Results:
- Overall survival was 50%. Patients undergoing surgery had an 82% survival rate versus 11% for non-surgical patients.
- Reasons for non-surgery included disease severity, altered mental state, and patient refusal due to operative risk.
- Non-surgical patients were older and had higher SOFA scores, longer steroid use, and higher CMV infection rates.
Conclusions:
- Underlying disease severity and operative risk concerns are primary barriers to surgery in pulmonary mucormycosis.
- Pulmonary resection surgery is the sole favorable survival factor, underscoring its critical importance.
- Timely lung resection is essential for improving survival in pulmonary mucormycosis, despite potential perioperative risks.
Related Concept Videos
01:19Factors Affecting Pulmonary Ventilation
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
01:29Factors Affecting Protein-Drug Binding: Patient-Related Factors
Age stands as a key determinant in protein-drug binding. Neonates, characterized by low albumin content, experience heightened concentrations of unbound drugs such as phenytoin and...
01:28Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
01:18Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
02:24Predicting Reaction Outcomes