[A study of 152 cases of pulmonary fungal infection: reevaluation of the microbiological spectra].
OBJECTIVE
To investigate the microbiological spectra and clinical outcome of patients with pulmonary fungal infections.


METHODS
All the cases of clinically diagnosed pulmonary fungal infection from January 2002 to June 2006 were reevaluated according to the definitions of European Organization for Research and Treatment of Cancer/National Institute of Allergy and Infectious Diseases Mycosis Study Group (EORTC/MSG), and the etiology of the patients were analyzed.


RESULTS
Pulmonary fungal disease was classified as proven (n = 38), probable (n = 24), possible (n = 35) and colonization (n = 55). In the proven group, the most frequently encountered fungi were Aspergillus species (15/38), followed by Cryptococcus species (13/38), Candida species were rare (2/38). In the probable group, Aspergillus species and Aspergillus species + Candida species were among the most common pathogens; while in the possible group and the colonization group, Candida species were most frequently encountered. The mortality of patients with probable pulmonary fungal infection (58.3%) was higher than that of patients in the possible group (25.7%) or the colonization group (16.4%) (P = 0.001). Univariate analysis showed that only APACHE II score was associated with outcome of patients with "pulmonary Candida infections", and antifungal therapy did not improve the outcome of such patients.


CONCLUSIONS
The most frequently encountered fungi in patients with pulmonary fungal infections were Aspergillus species, followed by Cryptococcus species. Primary Candida pulmonary infections were rare.
Cao
Bin
B
Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China. caobin1999@yahoo.com
Cai
Bai-Qiang
BQ
Wang
Hui
H
Zhou
Chao-Yang
CY
Wang
Peng
P
Liu
Hong-Rui
HR
Zhang
Hong
H
Xu
Ling
L
Xu
Kai-Feng
KF
Xu
Wen-Bing
WB
Zhu
Yuan-Jue
YJ
Li
Xiao-Guang
XG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001228:Aspergillosis / Q000175:diagnosis; D001230:Aspergillus / Q000302:isolation & purification*; D002175:Candida / Q000302:isolation & purification; D002177:Candidiasis / Q000175:diagnosis; D003453:Cryptococcosis / Q000175:diagnosis; D003454:Cryptococcus / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008172:Lung Diseases, Fungal / Q000145:classification / Q000175:diagnosis* / Q000382:microbiology*; D008875:Middle Aged; D055815:Young Adult