Disseminated Zygomycosis: A Rare Cause of Infection in Patients With Hematologic Malignancies

Doucette, Karen; Galbraith, P.A.; Bow, Eric J.; Binda, B; Rendina, Assunta; Embil, John M.

doi:10.1097/00005373-200309000-00031

Cited by 4 publications

(2 citation statements)

References 9 publications

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“…Disseminated mucormycosis involves more than two contiguous organs. In 23–62% of the cases, it occurs in patients with haematological disease [13,47,64,86, 110,206,207,303–324] and, in most cases, the patient is deeply immunodepressed and suffering from neutropenia. Other risk‐factors for dissemination are the use of corticosteroids, immunodepression after solid‐organ transplant, chemotherapy and the use of deferoxamine.…”

Section: Disseminated Diseasementioning

confidence: 99%

Mucormycosis: an emerging disease?

Bouza

Muñóz

Guinea

2006

Clinical Microbiology and Infection

134

127

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A B S T R A C TMucormycosis is the third invasive mycosis in order of importance after candidiasis and aspergillosis and is caused by fungi of the class Zygomycetes. The most important species in order of frequency is Rhizopus arrhizus (oryzae). Identification of the agents responsible for mucormycosis is based on macroscopic and microscopic morphological criteria, carbohydrate assimilation and the maximum temperature compatible with its growth. The incidence of mucormycosis is approximately 1.7 cases per 1000 000 inhabitants per year, and the main risk-factors for the development of mucormycosis are ketoacidosis (diabetic or other), iatrogenic immunosuppression, use of corticosteroids or deferoxamine, disruption of mucocutaneous barriers by catheters and other devices, and exposure to bandages contaminated by these fungi. Mucorales invade deep tissues via inhalation of airborne spores, percutaneous inoculation or ingestion. They colonise a high number of patients but do not cause invasion. Mucormycosis most commonly manifests in the sinuses (39%), lungs (24%), skin (19%), brain (9%), and gastrointestinal tract (7%), in the form of disseminated disease (6%), and in other sites (6%). Clinical diagnosis of mucormycosis is difficult, and is often made at a late stage of the disease or post-mortem. Confirmation of the clinical form requires the combination of symptoms compatible with histological invasion of tissues. The probable diagnosis of mucormycosis requires the combination of various clinical data and the isolation in culture of the fungus from clinical samples. Treatment of mucormycosis requires a rapid diagnosis, correction of predisposing factors, surgical resection, debridement and appropriate antifungal therapy. Liposomal amphotericin B is the therapy of choice for this condition. Itraconazole is considered to be inappropriate and there is evidence of its failure in patients suffering from mucormycosis. Voriconazole is not active in vitro against Mucorales, and failed when used in vivo. Posaconazole and ravuconazole have good activity in vitro. The overall rate of mortality of mucormycosis is approximately 40%.

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Section: Disseminated Diseasementioning

confidence: 99%

Mucormycosis: an emerging disease?

Bouza

Muñóz

Guinea

2006

Clinical Microbiology and Infection

134

127

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“…The most common site of spread is the brain but metastatic necrotic lesions have also been found in the spleen, heart and other organs. Clinical manifestations include lethargy, changes in mental status or obtundation with or without a sudden onset of focal neurological signs 12. Agents of the Mucorales may cause infection in virtually any body site.…”

Section: Discussionmentioning

confidence: 99%

Mucormycosis: an atrocious mate of patients with diabetes

et al. 2013

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Mucormycosis also called zygomycosis is a rare infection caused by saprophytic aerobic fungus that belongs to a group of fungi called Mucoromycotina in the order Mucorales. Earlier these fungi were called Zygomycota but this scientific name has recently been changed. Mucormycosis can result in an acute, rapidly advancing and occasionally fatal disease caused by different fungi typically found in the soil and in association with decaying organic matter such as leaves, compost piles or rotten wood. These fungal infections are relatively infrequent; however, they occur in individuals who are debilitated in some major way and occasionally in groups of people with multiple penetrating injuries that are contaminated with soil and water from the environment. Mucormycosis is not contagious and does not spread from person to person.

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Zygomycoses in patients with acute leukaemia

et al. 2006

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Zygomycoses are rare invasive mould infections which mainly occur in immunocompromised patients, especially during prolonged neutropenia. The high mortality rate is due to a high failure rate of both intravital diagnosis and treatment. Exact diagnosis requires microscopic examination and proof by culture. The treatment consists of amphotericin B and surgical debridement. We report four recent cases of zygomycosis among 89 patients with intensively treated acute leukaemia at our institution. Three cases were breakthrough infections since the patients were under voriconazole treatment prior to diagnosis of zygomycosis. Only one patient had premortal diagnosis (paranasal sinus infection) and showed clinical response with amphotericin B and surgical debridement. A review of the literature of these emerging fungal infections is given and is focused on patients with acute leukaemia. In addition, the importance of autopsy as a tool for quality control and epidemiological studies is pointed out.

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Disseminated Zygomycosis: A Rare Cause of Infection in Patients With Hematologic Malignancies

Cited by 4 publications

References 9 publications

Mucormycosis: an emerging disease?

Mucormycosis: an emerging disease?

Mucormycosis: an atrocious mate of patients with diabetes

Zygomycoses in patients with acute leukaemia

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