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Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
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[Comparative bronchoscopic manifestations in pulmonary mucormycosis and invasive pulmonary aspergillosis]

X S Li1, J Xu1, P Zeng1

  • 1Department of Pulmonary and Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing 102218, China.

Zhonghua Jie He He Hu Xi Za Zhi = Zhonghua Jiehe He Huxi Zazhi = Chinese Journal of Tuberculosis and Respiratory Diseases
|March 12, 2026
PubMed

Insights

Pulmonary mucormycosis and invasive pulmonary aspergillosis are serious fungal infections. Bronchoscopic features, like mucormycelium and bronchial pulmonary cavity fistula, help distinguish between these conditions in immunocompromised patients.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Medical Mycology

Background:

  • Pulmonary mucormycosis (PM) and invasive pulmonary aspergillosis (IPA) are life-threatening opportunistic infections.
  • These infections commonly affect immunocompromised patients and invade the airways.

Purpose of the Study:

  • To systematically evaluate and compare the bronchoscopic features of PM and IPA.
  • To propose new morphological concepts for differentiating these fungal infections.

Main Methods:

  • Retrospective analysis of 46 PM and 41 IPA patients diagnosed between January 2018 and February 2025.
  • Systematic evaluation of bronchoscopic findings, including novel morphological concepts: 'mucormycelium', 'aspermycelium', and 'bronchial pulmonary cavity fistula'.

Main Results:

  • Mucormycelium was observed more frequently than aspermycelium.
  • PM patients showed higher prevalence of bronchial pulmonary cavity fistula, granulation tissue, lumen stenosis, lumen obstruction, and purulent secretions.
  • IPA patients more frequently presented with fungal spots; no significant differences in mucosal congestion or airway bleeding were noted.

Conclusions:

  • Bronchoscopic features are valuable for differentiating between pulmonary mucormycosis and invasive pulmonary aspergillosis.
  • The proposed morphological concepts aid in the diagnosis and management of these severe fungal infections.

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