Mucormycosis - Mucormycosis also known as Zygomycosis or Phycomycosis, is caused
by Phycomycetes fungi (Mucorales) found in the soil
and in decaying vegetation. The structure of these
fungi is characteristic - the hyphae are broad,
branch at ninety degrees, and are non-septate. All
of us are exposed to these fungi all the time but
immune- compromised people are susceptible to this
Predisposing Factors -
-Poorly controled diabetics
-with long standing acidosis
-specially if the persion is iron loaded. (The
fungal hyphae produce a substance called rhizoferrin,
which binds iron when it come in contact with it.
The iron-rhizoferrin complex is taken back inside
the cell, and the iron becomes available for vital
-persons on deferoxamine(DFO) therapy. DFO provides
iron to the fungus for its growth
-immunosuppressed patients (chronic steroid use,
organ transplantation, leukemia/lymphoma, and AIDS)
Mucormycosis is a fungal infection of -
- sinuses and brain. Most cases involve the
paranasal sinuses, spreading rapidly to the eye and
- Pulmonary mucormycosis,
As the infection spreads, blood vessels get
thrombosed and the tissue gets necrosed.
Mucormycosis is a rapidly spreading infection and
can be fatal if not treated aggressively.
Rhinocerebral mucormycosis (Sinus and brain)-
Fever, acute sinusitis, swelling and protrusion of
eye orbit (proptosis), dark nasal discharge and
swelling and redness of skin overlying sinuses (cellulitis)
Pulmonary mucormycosis (Lung)- Fever, cough,
blood in sputum, shortness of breath
Gastrointestinal mucormycosis- Abdominal
pain, vomiting blood
Renal mucormycosis (Kidney)- Flank pain,
Cutaneous mucormycosis (skin)- painful with
burning sensation, red coloured firm area on skin
with central darker area.
For diagnosis, CT Scan or MRI of the site involved,
may be performed.
Treatment- As the disease spread is rapid,
aggressive treatment is required. Radical surgery to
remove all the dead tissues done. Which may lead to
disfigurement because of removal of the eye even
with good vision, nose, palate or part of face etc.
Without this type of surgery, chances of survival
are very, very less. Side by side FUNGISOME® (1-3 mg) is recommended. In cases of Rhinocerebral
mucormycosis, Amphotericin B can be given
intrathecical or intraventricular. Amphotericin B
can also be given interstitially. Even after
aggressive treatment, mortality rate is up to 80%.