What is mucormycosis?

Definition

Mucormycosis is a serious infection caused by a fungus that
affects the sinuses, brain, and lungs. The infection occurs most often in people
who have a compromised immune system. The prognosis is usually poor, even with treatment.

Causes

The fungus is often found in soil and in decaying plants. It will not make most people sick. People are more likely to get the infection if they have a weakened immune system.

Risk Factors

The factors that increase the chance of developing mucormycosis include having
a weakened immune system caused by diabetes, acquired immunodeficiency
syndrome, leukemia, or lymphoma; recently
receiving an organ transplant; long-term steroid use; treatment with deferoxamine
(an antidote to iron poisoning); metabolic acidosis (too much acid in the blood);
having a sinus infection or pneumonia; and having mucormycosis of
the gastrointestinal tract, skin, or kidneys.

Symptoms

Symptoms of mucormycosis depend on the location of the infection. Infections of
the sinuses and the brain (rhinocerebral mucormycosis) include acute sinusitis,
fever, swollen or protruding eyes, dark nasal scabs, and redness of the skin over
the sinuses. Symptoms of infections of the lungs (pulmonary mucormycosis) include fever, cough, coughing up blood, and
shortness of breath. Symptoms of infections of the gastrointestinal tract (gastrointestinal mucormycosis) include abdominal pain and vomiting
blood. Symptoms of infections in the kidneys (renal mucormycosis) include fever and pain in the side between the
upper abdomen and the back.

Screening and Diagnosis

A doctor will ask about symptoms and medical history and will perform a
physical exam. Tests might include a magnetic resonance imaging (MRI) scan
(a scan that uses radio waves and a powerful magnet to produce detailed computer
images), a computed tomography (CT) scan (a detailed X-ray picture that
identifies abnormalities of fine tissue structure), and an analysis of a tissue
sample.

Treatment and Therapy

Treatment options for mucormycosis include aggressive surgery to remove all the dead or infected tissue; early surgery may improve the prognosis. Another treatment is antifungal therapy, in which IV antifungal medications are used to kill the fungus throughout the body; even with this treatment, however, the prognosis is usually poor.

Prevention and Outcomes

The fungus that causes mucormycosis is found in many places, so avoiding contact with it is difficult. The best prevention is to control or prevent the conditions related to this infection.

Bibliography

Alcamo, I. Edward. Microbes and Society: An Introduction to Microbiology. 2d ed. Sudbury, Mass.: Jones and Bartlett, 2008.

Murray, Patrick R., Ken S. Rosenthal, and Michael A. Pfaller. Medical Microbiology. 6th ed. Philadelphia: Mosby/Elsevier, 2009.

Radha, S., et al. “Gastric Zygomycosis (Mucormycosis).” Internet Journal of Pathology 5, no. 2 (2007).

Roden, M. M., et al. “Epidemiology and Outcome of Mucormycosis: A Review of 929 Reported Cases.” Clinical Infectious Diseases 41, no. 5 (September, 2005): 634-653.

Sugar, A. M. “Agents of Mucormycosis and Related Species.” In Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, edited by Gerald L. Mandell, John F. Bennett, and Raphael Dolin. 7th ed. New York: Churchill Livingstone/Elsevier, 2010.