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Risk factors for mortality in patients with pulmonary mucormycosis

Hyo-Ju Son1,2, Joon Seon Song3, Sungim Choi4

  • 1Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Mycoses
|April 19, 2020
PubMed
Abstract

Insights

Pulmonary mucormycosis (PM) has a high mortality rate, with prolonged neutropenia and empirical voriconazole use being independent risk factors. Caution is advised when using voriconazole, even with positive galactomannan results.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Pulmonary mucormycosis (PM) poses a significant threat to immunocompromised individuals, leading to high morbidity and mortality.
  • Limited studies have explored prognostic factors in PM due to small patient cohorts.

Purpose of the Study:

  • To identify prognostic factors associated with mortality in patients diagnosed with pulmonary mucormycosis (PM).
  • To analyze risk factors contributing to fatal outcomes in PM cases.

Main Methods:

  • Retrospective analysis of adult patients diagnosed with proven or probable PM between 2008 and 2019.
  • Utilized modified EORTC/MSG 2008 definitions for diagnosis in a tertiary hospital setting.

Main Results:

  • A 90-day mortality rate of 49% was observed in the 49 enrolled patients.
  • Independent risk factors for mortality included prolonged neutropenia and empirical voriconazole use.
  • Voriconazole use was linked to positive galactomannan assays and a history of invasive pulmonary aspergillosis.

Conclusions:

  • Approximately half of PM patients died within 90 days.
  • Prolonged neutropenia and empirical voriconazole treatment are associated with fatal outcomes.
  • Careful consideration of voriconazole is necessary, especially in patients with positive galactomannan or prior invasive pulmonary aspergillosis.
Keywords:
galactomannaninvasive pulmonary aspergillosismortalitymucormycosisneutropeniapolyenespulmonary mucormycosisvoriconazole

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