{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T17:07:52Z","timestamp":1783098472564,"version":"3.54.6"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Pulmonary mucormycosis is a rare and often fatal fungal infection. Identifying high-risk factors for pulmonary mucormycosis holds the potential to improve patient outcomes. This study aimed to identify the clinical characteristics and risk factors associated with pulmonary mucormycosis outcomes in a Chinese cohort.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Materials and methods<\/jats:title>\n<jats:p>A retrospective analysis was conducted on 37 patients diagnosed with pulmonary mucormycosis, focusing on clinical records, laboratory findings, and computed tomography (CT) imaging. Diagnosis was primarily based on histopathology or next-generation sequencing.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The median age of the patients was 55 years, and the most common underlying conditions were hematological malignancies, diabetes, and organ transplantation. Imaging frequently revealed bilateral lung involvement with ground-glass opacities and nodular lesions. The overall mortality rate was 29.7%, with significant risk factors for 90-day mortality including hypertension (Hazard Ratio [HR] = 3.36, 95% Confidence Interval [CI] = 1.01\u201311.12, P\u2009=\u20090.048), organ transplantation (HR\u2009=\u20094.93, 95% CI\u2009=\u20091.48\u201316.4, P\u2009=\u20090.009), and immunosuppression (HR\u2009=\u20098.83, 95% CI\u2009=\u20091.13\u201369.14, P\u2009=\u20090.038).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Early suspicion and timely diagnostic measures, such as biopsy or metagenomic sequencing, are crucial for improving patient outcomes. These findings underscore the importance of recognizing and managing pulmonary mucormycosis in high-risk populations.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0323624","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T17:37:53Z","timestamp":1747417073000},"page":"e0323624","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Diagnosis, clinical features, and mortality risk factors in a Chinese cohort with pulmonary mucormycosis"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2452-8305","authenticated-orcid":true,"given":"Junjun","family":"Wan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3310-1211","authenticated-orcid":true,"given":"Teng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9762-080X","authenticated-orcid":true,"given":"Fang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9592-3151","authenticated-orcid":true,"given":"Shaohua","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"key":"pone.0323624.ref001","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.mycres.2007.03.004","article-title":"A higher-level phylogenetic classification of the Fungi","volume":"111","author":"DS Hibbett","year":"2007","journal-title":"Mycol Res"},{"issue":"7","key":"pone.0323624.ref002","doi-asserted-by":"crossref","DOI":"10.1016\/S1473-3099(23)00692-8","article-title":"Global incidence and mortality of severe fungal disease","volume":"24","author":"DW Denning","year":"2024","journal-title":"Lancet Infect Dis"},{"issue":"12","key":"pone.0323624.ref003","doi-asserted-by":"crossref","DOI":"10.1016\/S1473-3099(19)30312-3","article-title":"Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium","volume":"19","author":"OA Cornely","year":"2019","journal-title":"Lancet Infect Dis"},{"key":"pone.0323624.ref004","doi-asserted-by":"crossref","DOI":"10.3390\/jof6040265","article-title":"Epidemiology and diagnosis of mucormycosis: an update","volume":"6","author":"A Skiada","year":"2020","journal-title":"J Fungi"},{"issue":"4","key":"pone.0323624.ref005","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1086\/590004","article-title":"Delaying amphotericin B-based frontline therapy significantly increases mortality among patients with hematologic malignancy who have zygomycosis","volume":"47","author":"G Chamilos","year":"2008","journal-title":"Clin Infect Dis"},{"issue":"12","key":"pone.0323624.ref006","doi-asserted-by":"crossref","first-page":"1859","DOI":"10.1111\/j.1469-0691.2010.03456.x","article-title":"Zygomycosis in Europe: analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on Zygomycosis between 2005 and 2007","volume":"17","author":"A Skiada","year":"2011","journal-title":"Clin Microbiol Infect"},{"key":"pone.0323624.ref007","doi-asserted-by":"crossref","DOI":"10.1093\/cid\/cir880","article-title":"A global analysis of mucormycosis in France: the retrozygo study (2005-2007)","volume":"54","author":"F Lanternier","year":"2012","journal-title":"Clin Infect Dis"},{"issue":"9","key":"pone.0323624.ref008","doi-asserted-by":"crossref","first-page":"2166","DOI":"10.1111\/j.1600-6143.2009.02754.x","article-title":"Pulmonary zygomycosis in solid organ transplant recipients in the current era","volume":"9","author":"H-Y Sun","year":"2009","journal-title":"Am J Transplant"},{"key":"pone.0323624.ref009","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.cmi.2020.12.035","article-title":"Has the mortality from pulmonary mucormycosis changed over time? 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