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December 22, 2020

What is Mucormycosis


What is Mucormycosis 

Mucormycosis (formerly called zygomycosis) is a serious but rare fungal infection caused by a group of molds called mucormycetes.  These molds live throughout the environment.  Mucormycosis mainly affects people who have health problems or take medicines that lower the body's ability to fight germs and sickness.  It most commonly affects the sinuses or lungs after inhaling fungal spores from the air, or the skin after the fungus enters the skin through a cut, burn, or other type of skin injury.  However, it can occur in almost any part of the body.  

Types of Mucormycosis 

Rhinocerebral (sinus and brain) Mucormycosis is an infection in the sinuses that can spread to the brain.  This form of mucormycosis is most common in people with uncontrolled diabetes and in people who have had a kidney transplant.  Pulmonary (lung) mucormycosis is the most common type of mucormycosis in people with cancer and in people who have had an organ transplant or a stem cell transplant.  

Gastrointestinal mucormycosis is more common among young children than adults, especially premature and low birth weight infants less than 1 month of age, who have had antibiotics, surgery, or medications that lower the body's ability to fight germs and sickness.  Cutaneous (skin) mucormycosis: occurs after the fungi enter the body through a break in the skin (for example, after surgery, a burn, or other type of skin trauma).  This is the most common form of mucormycosis among people who do not have weakened immune systems.  Disseminated mucormycosis occurs when the infection spreads through the bloodstream to affect another part of the body.  The infection most commonly affects the brain, but can also affect other organs such as the spleen, heart, and skin.

Types of fungi that most commonly cause mucormycosis are Rhizopus species, Mucor species, Rhizomucor species, Syncephalastrum species, C unninghamella bertholletiae, Apophysomyces species, and Lichtheimia (formerly Absidia) species.  2 Symptoms of Mucormycosis The symptoms of mucormycosis depend on where in the body the fungus is growing.  Symptoms of rhinocerebral (sinus and brain) mucormycosis include:.  .  One - sided facial swelling Headache Nasal or sinus congestion Black lesions on nasal bridge or upper inside of mouth that quickly become more severe Fever o Symptoms of pulmonary (lung) mucormycosis include. 

Fever Cough Chest pain Shortness of breath o Cutaneous (skin) mucormycosis can look like blisters or ulcers, and the infected area may turn black.  Other symptoms include pain, warmth, excessive redness, or swelling around a wound.  Symptoms of gastrointestinal mucormycosis include: o Abdominal pain Nausea and vomiting gastrointestinal bleeding. 

Prevention of mucormycosis 

Protect yourself from the environment.  It's important to note that although these actions are recommended, they haven't been proven to prevent mucormycosis.  Wear an N95 respirator face mask. 

 Avoid direct contact with lots of dust like constructions, water - damaged buildings and natural disasters.  Wear shoes, long pants, and a long - sleeved shirt when doing outdoor activities.  Wear gloves when handling materials such as soil, moss, or manure.  Clean skin injuries well with soap and water, especially if they have been exposed to soil or dust.  

Diagnosis and testing for Mucormycosis. 

  A medical history, symptoms, physical examinations, and laboratory tests when diagnosing mucormycosis.  Definitive diagnosis of mucomycosis typically requires histopathological evidence or positive culture from a specimen from the site of infection.  Tissue biopsy, in which a small sample of affected tissue is analyzed in a laboratory for evidence of mucormycosis under a microscope or in a fungal culture.  CT scan of lungs, sinuses, or other parts of your body, depending on the location of the suspected infection.  

 Treatment for Mucormycosis

 Mucormycosis is a serious infection and needs to be treated with prescription antifungal medicine, usually amphotericin B, posaconazole, or isavuconazole.  These medicines are given through a vein (amphotericin B, posaconazole, isavuconazole) or by mouth (posaconazole, isavuconazole).  Other medicines, including fluconazole, voriconazole, and echinocandins, do not work against fungi that cause mucormycosis.  Often, mucormycosis requires surgery to cut away the infected tissue.  The overall prognosis depends on several factors, including the rapidity of diagnosis and treatment, the site of infection, and the patient's underlying conditions and degree of immunosuppression.  The overall mortality rate is approximately 50%, although early identification and treatment can lead to better outcomes.

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