Mucormycosis is an opportunistic zygomycete fungal infection that can cause many diseases. In most situations, the hosts are predisposed to infection due to underlying disorders. Since the fungi involved are common environmental organisms, they are frequently non-pathologic in immunocompromised patients.
However, these harmless organisms can cause a catastrophic and complicated opportunistic infection in such individuals. Mucormycosis is characterized by tissue necrosis caused by blood vessel invasion and subsequent thrombosis, which generally occurs rapidly. Early and rigorous operative debridement and large dosages of intravenous antifungal medication are crucial for treatment.
Epidemiology
Mucorales are temperature-sensitive fungi found in decomposing debris and soil, rarely pathogenic due to their poor virulence.
Mucormycosis has become more common as the general population’s incidence of immunosuppression has increased due to improved survival in cancer and transplant patients and broader indications for immunosuppressive drugs for different autoimmune illnesses.
Anatomy
Pathophysiology
Mucorales are found in decaying matter and compost. In immunocompromised people, Mucorales spores that enter the respiratory tract abide by nasal mucus and are eradicated by sneezing or swallowing. If the mucous membranes are damaged, polymorphonuclear neutrophils phagocytose and destabilize the fungal structures.
Patients with neutrophil malfunction or neutropenia are at the most significant risk since neutrophils are the host’s defense against such infections. Clinically, this is found in bone marrow transplants, and leukemia is at the highest risk.
Diabetes patients typically with uncontrolled diabetes and high levels of circulating glucose create ideal conditions for the rapid growth of filamentous structures that bind to blood vessels and then infiltrate them, completely obstructing them in specific days and causing vast regions of ischemic necrosis.
Etiology
Mucormycosis is an infectious condition caused by a fungus of the Zygomycetes and Mucorales groups. The significant route of infection is by inhalation of air spores, which deposit in the paranasal sinus and lungs. Intake or direct skin contamination are two less common methods of infection.
Diabetes, malnutrition, lymphomas and leukemias, renal failure, organ transplant, burns, immunosuppressive medication, cirrhosis, and AIDS are also risk factors. Patients with diabetic ketoacidosis and dialysis patients on the iron-chelating agent deferoxamine are also more vulnerable to mucormycosis.
Patients with overt immunosuppression, receiving transplants, HIV, chronic steroids, or individuals on disease-modifying anti-rheumatic drugs may exhibit a quickly progressing necrotizing infection.
Genetics
Prognostic Factors
The prognosis is determined by the timeline of treatment intervention and the degree of the patient’s underlying immunodeficiency, with death ranging from 25-87%, based on the site of infection.
Disseminated infection, renal damage, central nervous system dysfunction, and insufficient response to medical therapy are all signs of severity and poor prognosis.
The capacity to reestablish a normal immunological state is the most critical prognostic factor. If this is not achievable, the outlook is consistently bleak. If immunocompetence can be temporarily restored, the prognosis improves.
Initial dose: take a dose of 372 mg orally or intravenously every 8 hours up to 6 doses for two days
Maintenance dose: take a dose of 372 mg orally or intravenously daily Dosage Modifications Renal impairment
Mild, moderate and severe: dose modification not required Hepatic impairment
Mild or moderate: dose modification not required
Severe: study not performed
Initial dose: 372 mg orally/Intravenous every 8 hours for 6 doses (48 hours)
Maintenance dose: 372 mg orally/Intravenous daily
Dose Adjustments
Dosage Modifications
Renal impairment
Mild, moderate and severe (including End Stage Renal Disease): dose adjustment is not necessary Hepatic impairment
Mild-moderate: dose adjustment is not necessary
Severe: Not studied
Future Trends
Media Gallary
References
https://www.ncbi.nlm.nih.gov/books/NBK544364/
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Mucormycosis is an opportunistic zygomycete fungal infection that can cause many diseases. In most situations, the hosts are predisposed to infection due to underlying disorders. Since the fungi involved are common environmental organisms, they are frequently non-pathologic in immunocompromised patients.
However, these harmless organisms can cause a catastrophic and complicated opportunistic infection in such individuals. Mucormycosis is characterized by tissue necrosis caused by blood vessel invasion and subsequent thrombosis, which generally occurs rapidly. Early and rigorous operative debridement and large dosages of intravenous antifungal medication are crucial for treatment.
Mucorales are temperature-sensitive fungi found in decomposing debris and soil, rarely pathogenic due to their poor virulence.
Mucormycosis has become more common as the general population’s incidence of immunosuppression has increased due to improved survival in cancer and transplant patients and broader indications for immunosuppressive drugs for different autoimmune illnesses.
Mucorales are found in decaying matter and compost. In immunocompromised people, Mucorales spores that enter the respiratory tract abide by nasal mucus and are eradicated by sneezing or swallowing. If the mucous membranes are damaged, polymorphonuclear neutrophils phagocytose and destabilize the fungal structures.
Patients with neutrophil malfunction or neutropenia are at the most significant risk since neutrophils are the host’s defense against such infections. Clinically, this is found in bone marrow transplants, and leukemia is at the highest risk.
Diabetes patients typically with uncontrolled diabetes and high levels of circulating glucose create ideal conditions for the rapid growth of filamentous structures that bind to blood vessels and then infiltrate them, completely obstructing them in specific days and causing vast regions of ischemic necrosis.
Mucormycosis is an infectious condition caused by a fungus of the Zygomycetes and Mucorales groups. The significant route of infection is by inhalation of air spores, which deposit in the paranasal sinus and lungs. Intake or direct skin contamination are two less common methods of infection.
Diabetes, malnutrition, lymphomas and leukemias, renal failure, organ transplant, burns, immunosuppressive medication, cirrhosis, and AIDS are also risk factors. Patients with diabetic ketoacidosis and dialysis patients on the iron-chelating agent deferoxamine are also more vulnerable to mucormycosis.
Patients with overt immunosuppression, receiving transplants, HIV, chronic steroids, or individuals on disease-modifying anti-rheumatic drugs may exhibit a quickly progressing necrotizing infection.
The prognosis is determined by the timeline of treatment intervention and the degree of the patient’s underlying immunodeficiency, with death ranging from 25-87%, based on the site of infection.
Disseminated infection, renal damage, central nervous system dysfunction, and insufficient response to medical therapy are all signs of severity and poor prognosis.
The capacity to reestablish a normal immunological state is the most critical prognostic factor. If this is not achievable, the outlook is consistently bleak. If immunocompetence can be temporarily restored, the prognosis improves.
Initial dose: take a dose of 372 mg orally or intravenously every 8 hours up to 6 doses for two days
Maintenance dose: take a dose of 372 mg orally or intravenously daily Dosage Modifications Renal impairment
Mild, moderate and severe: dose modification not required Hepatic impairment
Mild or moderate: dose modification not required
Severe: study not performed
Initial dose: 372 mg orally/Intravenous every 8 hours for 6 doses (48 hours)
Maintenance dose: 372 mg orally/Intravenous daily
Dose Adjustments
Dosage Modifications
Renal impairment
Mild, moderate and severe (including End Stage Renal Disease): dose adjustment is not necessary Hepatic impairment
Mild-moderate: dose adjustment is not necessary
Severe: Not studied
https://www.ncbi.nlm.nih.gov/books/NBK544364/
medtigo
Mucormycosis
Updated :
August 24, 2023
Mucormycosis is an opportunistic zygomycete fungal infection that can cause many diseases. In most situations, the hosts are predisposed to infection due to underlying disorders. Since the fungi involved are common environmental organisms, they are frequently non-pathologic in immunocompromised patients.
However, these harmless organisms can cause a catastrophic and complicated opportunistic infection in such individuals. Mucormycosis is characterized by tissue necrosis caused by blood vessel invasion and subsequent thrombosis, which generally occurs rapidly. Early and rigorous operative debridement and large dosages of intravenous antifungal medication are crucial for treatment.
Mucorales are temperature-sensitive fungi found in decomposing debris and soil, rarely pathogenic due to their poor virulence.
Mucormycosis has become more common as the general population’s incidence of immunosuppression has increased due to improved survival in cancer and transplant patients and broader indications for immunosuppressive drugs for different autoimmune illnesses.
Mucorales are found in decaying matter and compost. In immunocompromised people, Mucorales spores that enter the respiratory tract abide by nasal mucus and are eradicated by sneezing or swallowing. If the mucous membranes are damaged, polymorphonuclear neutrophils phagocytose and destabilize the fungal structures.
Patients with neutrophil malfunction or neutropenia are at the most significant risk since neutrophils are the host’s defense against such infections. Clinically, this is found in bone marrow transplants, and leukemia is at the highest risk.
Diabetes patients typically with uncontrolled diabetes and high levels of circulating glucose create ideal conditions for the rapid growth of filamentous structures that bind to blood vessels and then infiltrate them, completely obstructing them in specific days and causing vast regions of ischemic necrosis.
Mucormycosis is an infectious condition caused by a fungus of the Zygomycetes and Mucorales groups. The significant route of infection is by inhalation of air spores, which deposit in the paranasal sinus and lungs. Intake or direct skin contamination are two less common methods of infection.
Diabetes, malnutrition, lymphomas and leukemias, renal failure, organ transplant, burns, immunosuppressive medication, cirrhosis, and AIDS are also risk factors. Patients with diabetic ketoacidosis and dialysis patients on the iron-chelating agent deferoxamine are also more vulnerable to mucormycosis.
Patients with overt immunosuppression, receiving transplants, HIV, chronic steroids, or individuals on disease-modifying anti-rheumatic drugs may exhibit a quickly progressing necrotizing infection.
The prognosis is determined by the timeline of treatment intervention and the degree of the patient’s underlying immunodeficiency, with death ranging from 25-87%, based on the site of infection.
Disseminated infection, renal damage, central nervous system dysfunction, and insufficient response to medical therapy are all signs of severity and poor prognosis.
The capacity to reestablish a normal immunological state is the most critical prognostic factor. If this is not achievable, the outlook is consistently bleak. If immunocompetence can be temporarily restored, the prognosis improves.
https://www.ncbi.nlm.nih.gov/books/NBK544364/
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