CT Features for Prognostic Assessment of Pulmonary Mucormycosis in Patients With Hematological Diseases

Purpose: To explore the CT features in prognostic evaluations for pulmonary mucormycosis in patients with hematological diseases. Materials and Methods: A retrospective analysis of clinical data and chest CT features of 53 HD patients with PM was conducted. Univariate and multivariate logistic regression analyses were used to determine the risk factors for death. The Cox regression model was used to analyze the factors affecting the survival rate. Results: A total of 30 patients with proven PM and 23 with probable PM were included. All 30 patients with proven PM underwent bronchoscopy-guided biopsy, among which 9 cases underwent surgical resection. Of the 23 patients with probable PM, 5 cases had positive results in sputum smear microscopy, 4 cases in sputum culture, 13 cases in bronchoalveolar lavage fluid (BALF) microscopy, and 1 case in BALF culture. All identification of pathogen genera and partial species was conducted by metagenomic next-generation sequencing (mNGS) testing. In the multivariate regression analysis, the CT feature of multiple lesions (≥2) on the initial CT scan was an independent risk factor for mortality ( P =0.019). Cox survival analysis demonstrated a significantly lower survival rate ( P =0.043) in patients exhibiting the CT feature of multiple lesions on the initial CT scan. Conclusions: The CT feature of multiple lesions (≥2) on the initial CT may serve as an independent risk factor for mortality in patients with hematologic disorders with pulmonary mucormycosis.