Multiple diagnostic methods for mucormycosis: A retrospective case series

• Published in: Journal of clinical laboratory analysis 2022-08, Vol.36 (8), p.e24588-n/a
• Main Authors: Wang, JiaXin, Wang, YaoMin, Han, Fei, Chen, JiangHua
• Format: Article
• Language: English
• Subjects: Biopsy; Bronchopulmonary infection; Cancer therapies; Chemotherapy; Clinical outcomes; culture; Diabetes; Diagnosis; early diagnosis; Fungal infections; Kidney transplants; metagenomic next‐generation sequencing (mNGS); Metagenomics; Mucormycosis; Patients; Prognosis; Tomography; Tuberculosis
• ISSN: 0887-8013; 1098-2825
• DOI: 10.1002/jcla.24588

Background Mucormycosis is a rare invasive fungal disease with high mortality. Early diagnosis and targeted drugs are crucial to improving clinical outcomes. Methods We searched the electronic hospital database of the First Affiliated Hospital of Zhejiang University School of Medicine for adult patients with mucormycosis between 2000 and 2021. Demographic, clinical, treatment, and outcome data were collected and compared with the data in the relevant literature. Results Eleven cases of mucormycosis—four of multisite infection, one of skin infection, five of lung infection, and one of gastrointestinal infection—were found and analyzed. The patients were diagnosed mainly based on pathological and histological findings, and three patients had metagenomic next‐generation sequencing findings. Delayed diagnosis (i.e., diagnosis >7 days after patient admission or >30 days after onset of symptoms) results in poor prognosis compared with early diagnosis. Conclusions Improving awareness and shortening diagnosis time may improve the prognosis of mucormycosis. If mucormycosis is suspected, appropriate samples should be collected as soon as possible and submitted for biopsy, culture, or mNGS to confirm the diagnosis. Patient 8 was admitted to the hospital because of a cough and sputum for 3 days. Bronchoscopy was performed, and bronchoalveolar lavage fluid (BALF) was used for culture and mNGS. BALF mNGS revealed Rhizopus, and sputum fungal culture revealed a small amount of Rhizopus. Lung computed tomography (CT) changes in patient 8 from admission (October 12, 2021) to the first follow‐up after discharge (January 21, 2022) are shown in Figure 1.