Health Encyclopedia

Mucormycosis

Definition

Mucormycosis is a fungal infection of the sinuses, brain, or lungs that occurs primarily in people with immune disorders.

Alternative Names

Zygomycosis

Causes, incidence, and risk factors

Mucormycosis is caused by common fungi frequently found in the soil and in decaying vegetation. Most individuals are exposed to these fungi on a daily basis -- but people with immune disorders may be more susceptible to infection.

Conditions most commonly associated with mucormycosis include diabetes (usually poorly controlled diabetes), chronic steroid use, metabolic acidosis, organ transplantation, leukemia/lymphoma, treatment with deferoxamine, and AIDS.

Syndromes associated with mucormycosis include:

Rhinocerebral infection (infection of sinuses and brain)
- May start as a sinus infection
- May progress to involve inflammation of cranial nerves
- May cause blood clots that block vessels to the brain (thrombosis)
Pulmonary mucormycosis (lung involvement) -- pneumonia that gets worse quickly and may spread to the chest cavity, heart, and brain
Mucormycosis of the gastrointestinal tract, skin, and kidneys

Symptoms

Symptoms of rhinocerebral mucormycosis include:

Acute sinusitis (sinus pain or congestion)
Eye swelling and protrusion (proptosis)
Dark nasal eschar (scabbing)
Fever
Redness of skin overlying sinuses

Symptoms of lung (pulmonary) mucormycosis include:

Cough
Coughing blood (occasionally)
Fever
Shortness of breath

Symptoms of gastrointestinal mucormycosis include:

Abdominal pain
Vomiting blood

Symptoms of kidney (renal) mucormycosis include:

Fever
Flank (side) pain

Symptoms of skin (cutaneous) mucormycosis include a single, painful, hardened area of skin that may have a blackened center.

Signs and tests

Mucormycosis should be suspected if symptoms appear in individuals with immune disorders such as diabetes or those with weakened immune systems such as transplant recipients. Symptoms of rhinocerebral mucormycosis are most likely to occur among immunosuppressed people.

Depending on where the symptoms are, CT scans or MRIs may be done. Evaluation by an ear-nose-throat specialist is recommended if sinus involvement is suspected.

A tissue specimen must be taken and analyzed in order to make a definitive diagnosis of mucormycosis.

Treatment

Mucormycosis is treated right away with surgery to remove all dead and infected tissue, along with intravenous (directly into a vein) antifungal therapy. Surgical removal of infected tissue may be disfiguring because it may involve removal of the palate, parts of the nose, or parts of the eye. Withoutt his aggressive surgery, however, chances of survival are greatly decreased.

Expectations (prognosis)

Mucormycosis has an extremely high mortality rate even with aggressive surgical intervention. Death rates range from 25 - 80% depending on the body area involved and the individual's underlying immune problems.

Complications

Blindness (if the optic nerve is involved)
Clotting/blockage of brain or lung vessels (thrombosis)
Death
Loss of neurological function (nerve involvement)

Calling your health care provider

People with immune disorders (including diabetes) should seek medical attention if they develop fever, headache, sinus pain, eye swelling, or any of the other symptoms listed above.

Prevention

Because the fungi that cause mucormycosis are widespread, the most appropriate preventive measures involve improved control of the underlying illnesses associated with mucormycosis.

References

Stevens DA. Aspergillosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 360.

Review Date:12/3/2008
Reviewed By:David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.