Mucormycosis


Mucormycosis

Description, Causes and Risk Factors:

Infection with fungi of the order Mucorales; to be distinguished from zygomycosis, a broader term that includes infections caused by fungi of the order Entomophthorales.

Mucormycosis is caused by a common fungus frequently found in the soil and in dying plants. Most people come in contact with the fungus at some time. However, people with a weakened immune system are more likely to get this infection. Generally, species in the Mucor, Rhizopus, Absidia, and Cunninghamella genera are most often implicated. This disease is often characterized by hyphae growing in and around vessels.

Conditions most commonly associated with mucormycosis include:

    AIDS.

  • Burns.

  • Diabetes (usually poorly controlled).

  • Leukemia and lymphoma.

  • Long-term steroid use.

  • Metabolic acidosis.

  • Poor nutrition (malnutrition).

Mucormycosis may involve:

Sinus and brain infection (rhinocerebral infection), which may start as a sinus infection, then causes swelling of the cranial nerves. It may cause blood clots that block vessels to the brain. Lung infection (pulmonary mucormycosis): pneumonia that gets worse quickly and may spread to the chest cavity, heart, and brain.

Other parts of the body: Mucormycosis of the gastrointestinal tract, skin, and kidneys.

In most cases, the prognosis of mucormycosis is poor and has varied mortality rates depending on its form and severity. In the rhinocerebral form, the mortality rate is between 30% and 70%, whereas disseminated mucormycosis presents with the highest mortality rate in an otherwise healthy patient, with a mortality rate of up to 90%. Patients with AIDS have a mortality rate of almost 100%. Possible complications of mucormycosis include the partial loss of neurological function, blindness and clotting of brain or lung vessels.

Symptoms:

Symptoms of rhinocerebral mucormycosis include:

    Eye swelling and protrusion (proptosis).

  • Dark nasal eschar (scabbing).

  • Fever.

  • Headache.

  • Mental status changes.

  • Redness of skin overlying sinuses.

  • Sinus pain or congestion.

Symptoms of Pulmonary (lung) mucormycosis include:

    Cough.

  • Coughing blood (occasionally).

  • Fever.

  • Shortness of breath.

Symptoms of gastrointestinal mucormycosis include:

    Abdominal pain.

  • Blood in the stools.

  • Diarrhea.

  • Vomiting blood.

Symptoms of Renal (kidney) mucormycosis include:

    Fever.

  • Flank (side) pain.

Diagnosis:

The doctor or nurse will examine you. An ear-nose-throat (ENT) specialist should be seen if you are having sinus problems.Testing depends on your symptoms but may include:

    CT scans.

  • MRI scans.

  • A biopsy must be done to make a definitive diagnosis of mucormycosis.

Treatment:

If mucormycosis is suspected, prompt amphotericin B therapy should be administered due to the rapid spread and mortality rate of the disease. Amphotericin B (which works by damaging the cell walls of the fungi) is usually administered for a further 4-6 weeks after initial therapy begins to ensure eradication of the infection. Posaconazole has been shown to be effective against mucormycosis, perhaps more so than amphotericin B, but has not yet replaced it as the standard of care.

Surgery should be done immediately to remove all dead and infected tissue. Surgery can lead to disfiguration because it may involve removal of the palate, parts of the nose, or parts of the eye. Without such aggressive surgery, however, chances of survival are greatly decreased. You will also receive antifungal medicines through a vein, usually amphotericin B.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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