Mucormycosis
Infection Mucormycosis Brief outline/clinical setting Mucormycosis is a fungal infection that usually occurs in the setting of an underlying compromising condition. Patients with mucormycosis most often present with rhino-cerebral or pulmonary syndromes caused by genera in the order Mucorales. Common risk factors include diabetes mellitus (particularly with ketoacidosis), treatment with glu
| Infection | Mucormycosis |
| Brief outline/clinical setting | Mucormycosis is a fungal infection that usually occurs in the setting of an underlying compromising condition. Patients with mucormycosis most often present with rhino-cerebral or pulmonary syndromes caused by genera in the order Mucorales. Common risk factors include diabetes mellitus (particularly with ketoacidosis), treatment with glucocorticoids, haematologic malignancies, treatment with certain iron chelators and iron overload. Rhino-orbito-cerebral mucormycosis occurs following inhalation of spores into the paranasal sinuses of a susceptible host. The infection usually presents with features of acute sinusitis, and subsequently spreads rapidly to the palate, orbit and brain. An eschar, which results from necrosis of tissues after vascular invasion of the fungus, may be visible in the palate, nasal mucosa and skin overlying the orbit. Erythema and cyanosis of the affected facial skin is often observed. |
| Aetiologies/organisms | Rhizophus species Mucor species Rhizomucor species Cunninghamella species Licthemia species |
| Optimal antimicrobial selection |
Primary therapy: Duration: Several weeks until significant clinical improvement (with aggressive surgical debridement) Step-down therapy
Day 1 - 300mg 12 hourly, thereafter 300mg daily with food
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| Duration | Until resolution of symptoms, complete resolution on imaging AND reversal of predisposing factors |
| Alternative if allergic/not available | Amphotericin B deoxycholate 1-1.5 mg/kg/day |
| Rationale | ESCMID and ECMM joint clinical guidelines for the diagnosis and management of mucormycosis 2019 |
| Level of evidence | |
| Link to Guideline | Click here |