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Delaying diagnostic procedure significantly increases mortality in patients with invasive mucormycosis

Authors
 Su Jin Jeong  ;  Ji Un Lee  ;  Young Goo Song  ;  Kyoung Hwa Lee  ;  Min Joo Lee 
Citation
 Mycoses, Vol.58(12) : 746-752, 2015 
Journal Title
 Mycoses 
ISSN
 0933-7407 
Issue Date
2015
MeSH
Aged ; Antifungal Agents/therapeutic use ; Delayed Diagnosis* ; Female ; Hematologic Neoplasms/therapy ; Humans ; Immunocompromised Host/immunology ; Male ; Middle Aged ; Mucormycosis/diagnosis* ; Mucormycosis/drug therapy ; Mucormycosis/mortality* ; Renal Insufficiency/complications ; Republic of Korea/epidemiology ; Retrospective Studies ; Survival Rate ; Tertiary Care Centers ; Thrombocytopenia/complications ; Time Factors ; Time-to-Treatment ; Treatment Outcome
Keywords
Mucormycosis ; delayed diagnosis ; mortality ; risk factor
Abstract
Invasive mucormycosis is an uncommon but increasing life-threatening fungal infection. The present study investigated clinical characteristics and mortality among patients diagnosed as invasive mucormycosis infection. We retrospectively reviewed a total of 24 histologically proven cases of invasive mucormycosis at two tertiary care referral hospitals between November 2005 and February 2014. Overall survival was 50% (n = 12). The time between onset of symptom and diagnostic procedure proved to be associated with mortality (P = 0.009). In addition, preexisting renal failure and thrombocytopenia demonstrated trends toward a poor outcome in our study (P = 0.089 and 0.065, respectively). On multivariate regression analysis, delayed diagnostic procedure (more than 16 days after the onset of symptoms) was an independent predictor of mortality (OR= 12.34, 95% CI, 1.43-10.64; P = 0.022). Mucormycosis is a destructive fungal infection that is associated with high mortality rates, ranging from 40% to 100% depending on the form of disease. When a clinician suspects invasive mucormycosis infection, an early diagnostic procedure performed within 16 days from the onset of symptom and early initiation of antifungal therapy will lead to successful management of this highly fatal disease.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/myc.12428/abstract
DOI
10.1111/myc.12428
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Lee, Kyoung Hwa(이경화) ORCID logo https://orcid.org/0000-0003-0033-1398
Lee, Minjoo(이민주)
Lee, Ji Un(이지운)
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/157110
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