Clinical Features and Outcome of Mucormycosis

Mucormycosis (MCM) is a life-threatening infection that carries high mortality rates despite recent advances in its diagnosis and treatment. The objective was to report 14 cases of mucormycosis infection and review the relevant literature. We retrospectively analyzed the demographic and clinical data of 14 consecutive patients that presented with MCM in a tertiary-care teaching hospital in northern Mexico. The mean age of the patients was 39.9 (range 5–65). Nine of the patients were male. Ten patients had diabetes mellitus as the underlying disease, and 6 patients had a hematological malignancy (acute leukemia). Of the diabetic patients, 3 had chronic renal failure and 4 presented with diabetic ketoacidosis. All patients had rhinocerebral involvement. In-hospital mortality was 50%. All patients received medical therapy with polyene antifungals and 11 patients underwent surgical therapy. Survivors were significantly younger and less likely to have diabetes than nonsurvivors, and had higher levels of serum albumin on admission. The clinical outcome of patients with MCM is poor. Uncontrolled diabetes and age are negative prognostic factors.

[1]  A. Shorr,et al.  Hospital days, hospitalization costs, and inpatient mortality among patients with mucormycosis: a retrospective analysis of US hospital discharge data , 2014, BMC Infectious Diseases.

[2]  L. Pagano,et al.  ESCMID and ECMM joint clinical guidelines for the diagnosis and management of mucormycosis 2013. , 2014, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[3]  B. Spellberg,et al.  Pathogenesis of mucormycosis. , 2012, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[4]  C. Elie,et al.  A global analysis of mucormycosis in France: the RetroZygo Study (2005-2007). , 2012, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[5]  D. Kontoyiannis,et al.  Epidemiology and clinical manifestations of mucormycosis. , 2012, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[6]  P. Hamal,et al.  Zygomycosis in Europe: analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on Zygomycosis between 2005 and 2007. , 2011, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[7]  A. Papadas,et al.  Rhinocerebral mucormycosis: an update. , 2010, European review for medical and pharmacological sciences.

[8]  A. Simon,et al.  Forty-one recent cases of invasive zygomycosis from a global clinical registry. , 2009, The Journal of antimicrobial chemotherapy.

[9]  B. Spellberg,et al.  Recent advances in the management of mucormycosis: from bench to bedside. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[10]  C. Romano,et al.  Zygomycosis in Italy: A Survey of FIMUA-ECMM (Federazione Italiana Di Micopatologia Umana ed Animale and European Confederation of Medical Mycology) , 2009, Journal of chemotherapy.

[11]  T. Turunç,et al.  Eleven cases of mucormycosis with atypical clinical manifestations in diabetic patients. , 2008, Diabetes research and clinical practice.

[12]  Patricia Muñoz,et al.  Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[13]  A. Chakrabarti,et al.  Mucormycosis in immunocompetent individuals: an increasing trend. , 2005, The Journal of otolaryngology.

[14]  D. Kontoyiannis,et al.  Epidemiology and outcome of zygomycosis: a review of 929 reported cases. , 2005, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[15]  N. Katsilambros,et al.  Mucormycosis: Ten-Year Experience at a Tertiary-Care Center in Greece , 2003, European Journal of Clinical Microbiology and Infectious Diseases.

[16]  E. Abemayor,et al.  Rhinocerebral Mucormycosis: Evolution of the Disease and Treatment Options , 1997, The Laryngoscope.

[17]  F. Bosques-Padilla,et al.  Rhinocerebral and systemic mucormycosis. Clinical experience with 36 cases , 1996, Journal of the Neurological Sciences.

[18]  A. Welch,et al.  STUDIES OF OPPORTUNISTIC FUNGI: I. INHIBITION OF RHIZOPUS ORYZAE BY HUMAN SERUM , 1961, The American journal of the medical sciences.