Mucormycosis

Mucormycosis is predominantly a disease of immunocompromised patients.

Five types are commonly described: rhino-orbito-cerebral (most common), pulmonary, cutaneous, disseminated, and gastrointestinal (rare).

Definitive diagnosis requires positive fungal culture or detection of fungal DNA through molecular testing (where available).

Rhinocerebral mucormycosis commonly occurs in patients with diabetes mellitus and presents with headache, visual changes, sinusitis, and, later, proptosis.

Pulmonary mucormycosis commonly presents as a cough in patients with underlying malignancy or transplant (bone marrow or solid organ). Late diagnosis may result in dissemination, leading to high mortality.

High level of suspicion and early institution of combined medical therapy with amphotericin-B, surgical treatment, and immune restoration is essential for good outcomes.

Mucormycosis is a group of mould infections caused by fungi in the order Murocales.[1]Pham D, Howard-Jones AR, Sparks R, et al. Epidemiology, modern diagnostics, and the management of mucorales infections. J Fungi (Basel). 2023 Jun 12;9(6):659. https://pmc.ncbi.nlm.nih.gov/articles/PMC10304757 http://www.ncbi.nlm.nih.gov/pubmed/37367595?tool=bestpractice.com [2]Steinbrink JM, Miceli MH. Mucormycosis. Infect Dis Clin North Am. 2021 Jun;35(2):435-52. https://pmc.ncbi.nlm.nih.gov/articles/PMC10110349 http://www.ncbi.nlm.nih.gov/pubmed/34016285?tool=bestpractice.com ​​​ The most common manifestations are rhino-orbito-cerebral and pulmonary infections, followed by cutaneous, disseminated, and gastrointestinal infections.[3]Spellberg B, Edwards J Jr, Ibrahim A. Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev. 2005 Jul;18(3):556-69. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1195964 http://www.ncbi.nlm.nih.gov/pubmed/16020690?tool=bestpractice.com [4]Centers for Disease Control and Prevention. Mucormycosis: clinical overview of mucormycosis. Apr 2024 [internet publication]. https://www.cdc.gov/mucormycosis/hcp/clinical-overview/index.html ​​