Mucormycosis (previously called zygomycosis) is a serious but rare fungal infection caused by a group of molds called mucormycetes. These molds live throughout the environment. Mucormycosis mainly affects people who have health problems or take medicines that lower the body’s ability to fight germs and sickness. It most commonly affects the sinuses or the lungs after inhaling fungal spores from the air, or the skin after the fungus enters the skin through a cut, burn, or other type of skin injury. However, it can occur in nearly any part of the body.
• Rhinocerebral (sinus and brain) mucormycosis is an infection in the sinuses that can spread to the brain. This form of mucormycosis is most common in people with uncontrolled diabetes and in people who have had a kidney transplant.
• Pulmonary (lung) mucormycosis is the most common type of mucormycosis in people with cancer and in people who have had an organ transplant or a stem cell transplant.
• Gastrointestinal mucormycosis is more common among young children than adults, especially premature and low birth weight infants less than 1 month of age, who have had antibiotics, surgery, or medications that lower the body’s ability to fight germs and sickness.
• Cutaneous (skin) mucormycosis: occurs after the fungi enter the body through a break in the skin (for example, after surgery, a burn, or other type of skin trauma). This is the most common form of mucormycosis among people who do not have weakened immune systems.
• Disseminated mucormycosis occurs when the infection spreads through the bloodstream to affect another part of the body. The infection most commonly affects the brain, but also can affect other organs such as the spleen, heart, and skin.
Fungal Agents causing mucormycosis
Rhizopus species, Mucor species, Rhizomucor species, Syncephalastrum species, Cunninghamella bertholletiae, Apophysomyces species, and Lichtheimia (formerly Absidia) species.
The symptoms of mucormycosis depend on where in the body the fungus is growing.
Symptoms of rhinocerebral (sinus and brain) mucormycosis include:
• One-sided facial swelling
• Nasal or sinus congestion
• Black lesions on nasal bridge or upper inside of mouth that quickly become more severe
Symptoms of pulmonary (lung) mucormycosis include:
• Chest pain
• Shortness of breath
Cutaneous (skin) mucormycosis can look like blisters or ulcers, and the infected area may turn black. Other symptoms include pain, warmth, excessive redness, or swelling around a wound.
Symptoms of gastrointestinal mucormycosis include:
• Abdominal pain
• Nausea and vomiting
• Gastrointestinal bleeding
Disseminated mucormycosis typically occurs in people who are already sick from other medical conditions, so it can be difficult to know which symptoms are related to mucormycosis. Patients with disseminated infection in the brain can develop mental status changes or coma.
People at Risk
Certain groups of people are more likely to get mucormycosis, including people with:
• Diabetes, especially with diabetic ketoacidosis
• Organ transplant
• Stem cell transplant
• Long-term corticosteroid use
• Injection drug use
• Too much iron in the body (iron overload or hemochromatosis)
• Skin injury due to surgery, burns, or wounds
• Prematurity and low birthweight (for neonatal gastrointestinal mucormycosis)
Mode of transmission
People get mucormycosis through contact with fungal spores in the environment. For example, the lung or sinus forms of the infection can occur after someone inhales the spores from the air. A skin infection can occur after the fungus enters the skin through a scrape, burn, or other type of skin injury. Mucormycosis can’t spread between people or between people and animals.
• A Medical history, symptoms, physical examinations, and laboratory tests when diagnosing mucormycosis.
• Definitive diagnosis of mucormycosis typically requires histopathological evidence or positive culture from a specimen from the site of infection.
• Tissue biopsy, in which a small sample of affected tissue is analyzed in a laboratory for evidence of mucormycosis under a microscope or in a fungal culture.
• CT scan of lungs, sinuses, or other parts of your body, depending on the location of the suspected infection.
Mucormycosis is a serious infection and needs to be treated with prescription antifungal medicine, usually amphotericin B, posaconazole, or isavuconazole. These medicines are given through a vein (amphotericin B, posaconazole, isavuconazole) or by mouth (posaconazole, isavuconazole). Other medicines, including fluconazole, voriconazole, and echinocandins, do not work against fungi that cause mucormycosis. Often, mucormycosis requires surgery to cut away the infected tissue.
The overall prognosis depends on several factors, including the rapidity of diagnosis and treatment, the site of infection, and the patient’s underlying conditions and degree of immunosuppression. The overall mortality rate is approximately 50%, although early identification and treatment can lead to better outcomes.
• Protect yourself from the environment. It’s important to note that although these actions are recommended, they haven’t been proven to prevent mucormycosis.
• Wear an N95 respirator face mask.
• Avoid direct contact with lots of dust like constructions, water-damaged
buildings and natural disasters.
• Wear shoes, long pants, and a long-sleeved shirt when doing outdoor
• Wear gloves when handling materials such as soil, moss, or manure.
• Clean skin injuries well with soap and water, especially if they have been exposed to soil or dust.