Evaluation of 28 cases of mucormycosis

Abstract

Mucormycosis is a rare but invasive fungal disease with high mortality. The present study aimed to retrospectively investigate the demographic characteristics, as well as the clinical, radiological and laboratory features and the results of treatment, in the patients followed in our hospital because of mucormycosis. The present study retrospectively evaluated 28 cases, which were followed in our hospital because of mucormycosis between January 2002 and July 2013. The clinical form was rhinocerebral in 27 cases (rhinoorbital in 12, nasal in 8 and rhinoorbitocerebral in 7) and disseminated in one case. With regard to predisposing factors, diabetes mellitus (n = 20), haematological malignancy (n = 6) and chronic renal insufficiency (n = 5) were the leading concomitant diseases. Seventeen (61%) of 28 cases showed atypical clinical picture. With regard to the therapeutic outcomes; it was found that 14 (50%) cases died and six cases recovered with sequel. Today, when particularly the prevalence of immunosuppressive diseases and conditions are gradually increasing, the incidence of mucormycosis is also increased. Considering that the majority of our cases had atypical clinical involvement and complications, being familiar with the characteristics of this disease could be life-saving together with early diagnosis and treatment.

Imaging in Rhino-Orbital Mucormycosis

“…In their study by Kursun et al, 7 out of 26 cases similar to our study all the cases had paranasal sinus involvement in CT scan; 69% of the cases orbital lesions and 57% cranial lesions in MRI.…”

Cutaneous mucormycosis

“…Other signs are fever, periorbital cellulitis, periorbital edema, ophthalmoplegia, proptosis, loss of vision, and other neurological deficits. 29,30 The disease can be divided into three clinical stages: stage I, with signs and symptoms limited to the sino-nasal area; stage II, which is characterized by a sino-orbital infection; and stage III, which has intracranial involvement. 30 …”

Rhinocerebral Mucormycosis: Clinical Outcome, Diagnosis, Treatment – Review of the Literature

“…Most of them (79%) have a slightly increased temperature [19]. Initial symptoms of this disease usually suggest sinusitis.…”

“…Ptosis, pupil dilatation, ipsilateral face paresthesis indicate the involvement of the branches of the trigeminal and facial nerves. Kursun et al [19] point out that the orbital apex syndrome as one of atypical clinical symptoms, which may be caused by e.g., bacterial infections, tumors or sarcoidosis. This is due to the infection of the cranial nerves: II, III, IV, V 1 , VI.…”

“…MR is significantly more accurate [3,16]. Molecular techniques are very useful in order to determine the exact etiology of the disease, but should never be used as an only method of an examination [19]. Currently, there are also studies of specific T-cell for Mucor sp., focused in the differential diagnosis with aspergillosis.…”