Zygomycosis
| Zygomycosis | |
|---|---|
| Specialty | Infectious diseases  |
Mucormycosis (also known as zygomycosis) is a rare yet life threatening and serious infection of fungi of the Mucorales order, usually affecting the face or oropharyngeal cavity.[1] The most common fungi responsible for mucormycosis in humans are Mucor and Rhizopus. Other fungi include Apophysomyces, Absidia, Mortierella, Cunninghamella, Saksenaea, Syncephalastrum and Cokeromyces.[1] Differentials to consider in diagnosis of the infection include anthrax, aspergillosis and cellulitis.[citation needed]
History
Mucormycosis is a very rare infection, and as such it is hard to note histories of patients and incidence of the infection.[1] However, one American oncology center revealed that mucormycosis was found in 0.7% of autopsies and roughly 20 patients per every 100,000 admissions to that center.[2] In the United States, mucormycosis was most commonly found in the form of Rhinocerebral disease. In most cases the patient is immunocompromised, although rare cases have occurred in which the subject was not immunocompromised, most often due to a traumatic inoculation of fungal spores. Internationally, mucormycosis was found in 1% of patients with acute leukemia in an Italian review.[1]
Some 50-75% of patients diagnosed with mucormycosis are estimated to have underlying poorly controlled diabetes mellitus and ketoacidosis.
Symptoms
Mucormycosis frequently involves the sinuses, brain, or lungs as the sites of infection. Whilst orbitorhinocerebral mucormycosis is the most common type of the disease, this infection can also manifest in the gastrointestinal tract, skin, and in other organ systems.[1]
If Rhinocerbral disease is the cause of the the infection, symptoms may include unilateral, retro-orbital headache, facial pain, fevers, and nasal stuffiness that progresses to black discharge. However, in other forms of mucormycosis, symptoms may include dyspnea, persistent cough, hemoptysis (in cases of necrosis and nausea/vomiting).[1]
Diagnosis
As swabs of tissue or discharge are generally unreliable, the diagnosis of mucormycosis tends to be established by a biopsy specimen of the involved tissue. Computerised imaging techniques such as MRI's, CT Scan's and X-ray's may be useful in the diagnosis of specific areas.[1][2]
Treatment
If mucormycosis is suspected, prompt amphotericin B therapy should be administered due to the rapid spread and mortality rate of the disease. Amphotericin B (which works by altering the RNA and/or DNA of the fungi) is usually administered for a further 4-6 after initial therapy begins to ensure eradication of the infection. After administration the patient must then be admitted to surgery for removal of the "fungus ball". The disease must be monitored carefully for any signs of reemergence.[2]
Surgical therapy can be very drastic, and in some cases of Rhinocerebral disease removal of infected brain tissue may be required. Surgery may be extended to more than one operation.[1]
Prognosis
In most cases, the prognosis of mucormycosis is poor and has varied mortality rates depending on it's form and it's severity. In the Rhinocerebral form, the mortality rate is between 30% and 70%. Patient's with AIDS have a mortality rate of almost 100%.[2]
References
External links
- Articles on Mark Tatum, a victim of the disease.
- Tsunami survivors risk deadly fungal infections
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