Mucormycosis Overview
Etiology:
- Caused by fungi in the order Mucorales, including Rhizopus, Mucor, and Rhizomucor.
- These fungi are ubiquitous in the environment, found in soil and decaying organic matter.
Risk Factors:
- Uncontrolled diabetes, especially with ketoacidosis.
- Immunocompromised states (e.g., neutropenia, hematologic malignancies).
- Trauma, burns, and use of corticosteroids.
Pathogenesis:
- Spores are inhaled or enter through skin trauma, leading to germination in the sinuses, lungs, or skin.
- The fungi invade blood vessels, causing thrombosis and tissue necrosis.
Clinical Presentation:
- Rhino-orbital-cerebral mucormycosis: Facial pain, headache, nasal congestion, black necrotic eschar on the palate or nasal mucosa.
- Pulmonary mucormycosis: Fever, cough, hemoptysis, and chest pain.
- Cutaneous mucormycosis: Erythematous, necrotic papules, and plaques.
Diagnosis:
- High clinical suspicion in at-risk patients with sinusitis-like symptoms unresponsive to antibiotics.
- Biopsy showing non-septate hyphae with right-angle branching.
- Imaging (CT/MRI) showing sinus involvement, air-fluid levels, and bony destruction.
Treatment includes both:
- Medical: First-line antifungal is amphotericin B; isavuconazole as a second-line.
- Surgical: Biopsy and Debridement of necrotic tissue is essential.
Prognosis:
High mortality rate due to rapid progression.
Mnemonic for Mucormycosis:
MUCOR
M: Mucorales fungi
U: Uncontrolled diabetes
C: Cerebral involvement (rhino-orbital-cerebral)
O: Orbital swelling and black eschar
R: Rapid progression and high mortality
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This post covers the points you need to know for your board exams as well as for teaching residents on the daily rounds. Medical professionals can't use the information here to treat their patients nor people can use the information her to treat themselves. If you are having any medical issues, contact your local emergency services. Please refer to your doctor for medical advice.