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Mucormycosis
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Mucormycosis

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Zygomycosis

Mucormycosis is a fungal infection of the sinuses, brain, or lungs. It occurs in some people with a weakened immune system.

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  • Causes

    Mucormycosis is caused by a common fungus that is often found in the soil and in dying plants. Most people come in contact with the fungus at some time. However, people with a weakened immune system are more likely to get this infection.

    Conditions most commonly associated with mucormycosis include:

    • AIDS
    • Burns
    • Diabetes (usually poorly controlled)
    • Leukemia and lymphoma
    • Long-term steroid use
    • Metabolic acidosis
    • Poor nutrition (malnutrition)
    • Use of some medicines

    Mucormycosis may involve:

    • A sinus and brain infection called rhinocerebral infection: may start as a sinus infection, and then lead to the swelling of the nerves that stem from the brain. It may also cause blood clots that block vessels to the brain.
    • A lung infection called pulmonary mucormycosis: pneumonia gets worse quickly and may spread to the chest cavity, heart, and brain.
    • Other parts of the body: mucormycosis of the gastrointestinal tract, skin, and kidneys.
  • Symptoms

    Symptoms of rhinocerebral mucormycosis include:

    • Eyes that swell and stick out (protrude)
    • Dark scabbing in nasal cavities
    • Fever
    • Headache
    • Mental status changes
    • Redness of skin above sinuses
    • Sinus pain or congestion

    Symptoms of lung (pulmonary) mucormycosis include:

    • Cough
    • Coughing blood (occasionally)
    • Fever
    • Shortness of breath

    Symptoms of gastrointestinal mucormycosis include:

    • Abdominal pain
    • Blood in the stools
    • Diarrhea
    • Vomiting blood

    Symptoms of kidney (renal) mucormycosis include:

    • Fever
    • Pain in the upper abdomen or back

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

  • Exams and Tests

    Your health care provider will examine you. See an ear-nose-throat (ENT) doctor if you are having sinus problems.

    Testing depends on your symptoms, but may include these imaging tests:

    • CT scans
    • MRI scans

    A biopsy must be done to definitively diagnose mucormycosis.

  • Treatment

    Surgery should be done immediately to remove all dead and infected tissue. Surgery can lead to disfiguration because it may involve removal of the palate, parts of the nose, or parts of the eye. Without such aggressive surgery, however, chances of survival are greatly decreased.

    You will also receive antifungal medicine, usually amphotericin B, through a vein. After the infection is under control, you may be switched to a different medicine.

  • Outlook (Prognosis)

    Mucormycosis has an extremely high death rate, even when aggressive surgery is done. Risk of death depends on the area of the body involved and your overall health.

  • Possible Complications

    These complications may occur:

    • Blindness (if the optic nerve is involved)
    • Clotting or blockage of brain or lung blood vessels
    • Death
    • Nerve damage
  • When to Contact a Medical Professional

    People with weakened immune systems and immune disorders (including diabetes) should seek medical attention if they develop:

    • Fever
    • Headache
    • Sinus pain
    • Eye swelling
    • Any of the other symptoms listed above
  • Prevention

    Because the fungi that cause mucormycosis are widespread, the best way to prevent this infection is to improve control of the illnesses associated with mucormycosis.

Related Information

     

References

Kontoyiannis DP. Mucormycosis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 348.

Kontoyiannis DP, Lewis RE. Agents of mucormycosis and entomophthoramycosis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:chap 260.

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Review Date: 12/7/2014  

Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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