Mucormycosis
Mucormycosis is a serious fungal infection primarily affecting the sinuses, brain, and lungs. It is most prevalent among individuals with weakened immune systems, such as those with diabetes, cancer, or who have undergone organ transplants. The infection can manifest in various ways depending on its location, with symptoms ranging from acute sinusitis and fever to abdominal pain and coughing up blood. Diagnosis typically involves a combination of medical history evaluation, imaging tests like MRI or CT scans, and tissue analysis. Treatment often requires aggressive surgical intervention to remove affected tissue, along with intravenous antifungal medications, though the overall prognosis can be poor. Prevention largely revolves around managing underlying health conditions that predispose individuals to the infection. Given the challenges in avoiding exposure to the fungi, awareness and early intervention are crucial for those at risk.
Mucormycosis
- ANATOMY OR SYSTEM AFFECTED: Brain, central nervous system, lungs, respiratory system
- ALSO KNOWN AS: Zygomycosis
Definition
Mucormycosis is a serious infection caused by a fungus that affects the sinuses, brain, and lungs. It occurs most often in people with a compromised immune system, and the prognosis is usually poor, even with treatment.
Causes
The fungus is often found in soil and decaying plants. It does not make most people sick, but people with a weakened immune system are more likely to get the infection.
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. There are additional risk factors for mucormycosis, including severe COVID-19, premature birth, low birth weight, trauma, burns, surgery with possibly contaminated instruments, having a medial device implicated in one’s body, intravenous drug use, and certain medications.
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, redness of the skin over the sinuses, facial numbness, double vision, confusion, slurred speech, and paralysis. Symptoms of infections of the lungs (pulmonary mucormycosis) include fever, cough, coughing up blood, chest pain, wheezing, and shortness of breath. Symptoms of infections of the gastrointestinal tract (gastrointestinal mucormycosis) include abdominal pain, bloody diarrhea, constipation, 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 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. Additional tests for mucormycosis include polymerase chain reaction (PCR) and other DNA-based tests, blood tests, endoscopic examination, and other imaging tests, such as positron emission tomography (PET) scans.
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 intravenous antifungal medications are used to kill the fungus throughout the body; even with this treatment, however, the prognosis is usually poor. Additional treatments include hyperbaric oxygen therapy, broad-spectrum antifungal therapies, such as amphotericin B lipid formulations, combining multiple antifungal therapies, and adjuvant treatments to help manage symptoms.
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
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