Clinical Analysis Of Invasive Fungal Disease In 82 Patients With Hematologic Malignancies

Objective:To analyze the related risk factors,pathogenic bacteria characteristics and imaging findings of hematologic malignancies associated with invasive fungal disease,and to provide guidance for the early diagnosis of invasive fungal disease.Methods:A retrospective analysis of a total of 152 in-patients with hematologic malignancies during January 2012 to January 2017,82 cases of fungal infection case group,70 cases of bacterial infection as the control group.Collected the clinical features and summarized the high-risk factors related to the incidence of IFD.The statistical methods of chi-square test and Logistic regression to analyzed the data by using SPSS19.0 software.Result:82 cases of fungal infections,diagnosed in 4 cases,20 cases of clinical diagnosis,the proposed diagnosis of 58 cases,The incidence of acute myeloid leukemia in hematologic disease is the highest.The clinical manifestations and characteristics of IFD are lack of specificity.Lung is the main site of infection.CT scans is an important method for the diagnosis of IFD.The early diagnosis of nodules,wedges,halo,cavities and air crescent signs is of great significance.There were 11 episodes of fungi documented by blood or sputum culture in which the majority were Candida species at the rate of 72.72%.58 cases of effective treatment,24 cases of ineffective treatment,including 5 deaths.Univariate analysis showed that the difference of age,sexual distinction,whether the primary disease is relieved or not,the duration of broad-spectrum antibiotic,the degree of neutropenia,the duration of neutropenia were considered to be statistically significant(p<0.05).Multivariate unconditional logistic regression analysis showed that neutropenia?10days(p=0.000,OR=5.171),the duration of broad-spectrum antibiotic?7days(p=0.047,OR=3.651)were independent risk factors for malignant hematological malignancies with invasive fungal infection.Conclusions:The clinical manifestations and characteristics of patients with malignant hematopoiesis combined with invasive fungal disease are lack of specificity.The diagnosis rate of IFD is low,Its main infection site is lungs and main pathogenic bacteria are candida.In the clinical work,reduce the duration of neutropenia,and the rational use antibiotics,which is an important measure to prevent and reduce the occurrence of invasive fungal disease.