Health Dictionary

Overview

Mucormycosis can be classified according to the organ system involved including brain, lungs, skin, GIT, bones, liver, spleen. Disseminated infection affects multiple organ systems.

Classification

Mucormycosis may be classified based on the organ system involvement as follows:

Type	High risk group	Transmission	Signs and Symptoms	Complications
Rhinocerebral mucormycosis	It occurs most commonly in debilitated patients (specially those presenting with diabetic ketoacidosis)^[1] and those undergoing hematopoietic stem cell transplantation^{_Clinical_Infectious_Diseases_\|_Oxford_Academic-2\|[2]}	Rhinocerebral mucormycosis is by far the most common form of the disease. Acquired by: Perineural spread^[3] After proliferation in the nasal cavity, the mucor reaches the pterygo-palatine fossa, inferior orbital fissure and finally the retroglobal space of the orbit, leading to ocular signs The facial soft tissues, palate and infratemporal fossa can be infected through connecting pathways from the pterygo-palatine fossa^[4]	Eye or facial pain Facial numbness Facial ulceration and necrosis Conjunctival injection Blurry vision Soft tissue swelling^[5] ^[6] Bilateral proptosis Chemosis Vision loss Ophthalmoplegia Cavernous sinus thrombosis Bloody nasal discharge may be the first sign that infection has invaded through the turbinates and into the brain	Disseminated infection Mycotic aneurysms
Pulmonary mucormycosis	Most commonly occurs in neutropenic and stem cell transplant patients^[5]	Acquired by: Inhalation Hematogenous spread Lymphatic spread	Dyspnea Cough Chest pain Hemoptysis (if there is vessel involvement through vascular invasion)^[7]	Disseminated infection^[8]
Cutaneous mucormycosis		Acquired by disruption of the physiologic skin barrier: Trauma Skin maceration Burns Contaminated surgical dressings^{_JAMA_\|_The_JAMA_Network-9\|[9]}	Skin redness Numbness Warmth Skin ulceration and necrosis	Disseminated infection^[10]
Gastrointestinal mucormycosis	Usually found in malnourished individuals, AIDS patients, SLE patients, ^[11] organ transplant recepients,^[12] infants and children	Rare occurrence Acquired by: Ingestion of Fungi	Abdominal distension Pain Nausea Vomiting Hematochezia	Disseminated infection
Disseminated mucormycosis	Patients on immunosupressants and anti-fungal prophylaxis (escpecially voriconazole) are particularly susceptible to disseminated infection^[13]^{_Clinical_Infectious_Diseases_\|_Oxford_Academic-14\|[14]}	Acquired by: Hematogenous spread is usually the most common route of dissemination and pulmonary mucormycosis is usually the culprit	Brain is the most common site of dissemination leading to: Seizures Stroke Paralysis Abscess formation Splenic infarction Myocardial necrosis liver skin	High case fatality rate^[15]

References

↑ “Rhinocerebral mucormycosis: Predisposing factors – Mcnulty – 1982 – The Laryngoscope – Wiley Online Library”.
_Clinical_Infectious_Diseases_|_Oxford_Academic_2-0|↑ “Epidemiology and Outcome of Mould Infections in Hematopoietic Stem Cell Transplant Recipients | Clinical Infectious Diseases | Oxford Academic”.
↑ Margo CE, Linden C, Strickland-Marmol LB, Denietolis AL, McCaffrey JC, Kirk N (2007). “Rhinocerebral mucormycosis with perineural spread”. Ophthal Plast Reconstr Surg. 23 (4): 326–7. doi:10.1097/IOP.0b013e318070855b. PMID 17667114.
↑ Hosseini SM, Borghei P (2005). “Rhinocerebral mucormycosis: pathways of spread”. Eur Arch Otorhinolaryngol. 262 (11): 932–8. doi:10.1007/s00405-005-0919-0. PMID 15891927.
↑ Khor BS, Lee MH, Leu HS, Liu JW (2003). “Rhinocerebral mucormycosis in Taiwan”. J Microbiol Immunol Infect. 36 (4): 266–9. PMID 14723256.
↑ “Rhinocerebral Mucormycosis: Evolution of the Disease and Treatment Options – Peterson – 1997 – The Laryngoscope – Wiley Online Library”.
↑ Tedder M, Spratt JA, Anstadt MP, Hegde SS, Tedder SD, Lowe JE (1994). “Pulmonary mucormycosis: results of medical and surgical therapy”. Ann. Thorac. Surg. 57 (4): 1044–50. PMID 8166512.
↑ “Improved Outcome of Zygomycosis in Patients with Hematological Diseases?: Leukemia & Lymphoma: Vol 45, No 7”.
_JAMA_|_The_JAMA_Network_9-0|↑ “Cutaneous Rhizopus Infection | JAMA | The JAMA Network”.
↑ “Gangrenous Cutaneous Mucormycosis in a Child with a Solid Organ Transplant: A Case Report and Review of the Literature – Boyd – 2003 – Pediatric Dermatology – Wiley Online Library”.
↑ “www.nature.com” (PDF).
↑ “GASTRIC PERFORATION DUE TO MUCORMYCOSIS AFTER HEART-LUNG AND… : Transplantation”.
↑ “Zygomycosis in neutropenic patients with past Aspergillus infection: a role for posaconazole? – Ide – 2004 – Clinical Microbiology and Infection – Wiley Online Library”.
_Clinical_Infectious_Diseases_|_Oxford_Academic_14-0|↑ “Breakthrough Fungal Infections in Stem Cell Transplant Recipients Receiving Voriconazole | Clinical Infectious Diseases | Oxford Academic”.
↑ STRAATSMA BR, ZIMMERMAN LE, GASS JD (1962). “Phycomycosis. A clinicopathologic study of fifty-one cases”. Lab. Invest. 11: 963–85. PMID 13984484.

[urlRhinocerebral_mucormycosis:_Predisposing_factors_-_Mcnulty_-_1982_-_The_Laryngoscope_-_Wiley_Online_Library-1] “Rhinocerebral mucormycosis: Predisposing factors – Mcnulty – 1982 – The Laryngoscope – Wiley Online Library”.

[urlEpidemiology_and_Outcome_of_Mould_Infections_in_Hematopoietic_Stem_Cell_Transplant_Recipients_|_Clinical_Infectious_Diseases_|_Oxford_Academic-2] _Clinical_Infectious_Diseases_|_Oxford_Academic_2-0|↑ “Epidemiology and Outcome of Mould Infections in Hematopoietic Stem Cell Transplant Recipients | Clinical Infectious Diseases | Oxford Academic”.

[pmid17667114-3] Margo CE, Linden C, Strickland-Marmol LB, Denietolis AL, McCaffrey JC, Kirk N (2007). “Rhinocerebral mucormycosis with perineural spread”. Ophthal Plast Reconstr Surg. 23 (4): 326–7. doi:10.1097/IOP.0b013e318070855b. PMID 17667114.

[pmid15891927-4] Hosseini SM, Borghei P (2005). “Rhinocerebral mucormycosis: pathways of spread”. Eur Arch Otorhinolaryngol. 262 (11): 932–8. doi:10.1007/s00405-005-0919-0. PMID 15891927.

[pmid14723256-5] Khor BS, Lee MH, Leu HS, Liu JW (2003). “Rhinocerebral mucormycosis in Taiwan”. J Microbiol Immunol Infect. 36 (4): 266–9. PMID 14723256.

[urlRhinocerebral_Mucormycosis:_Evolution_of_the_Disease_and_Treatment_Options_-_Peterson_-_1997_-_The_Laryngoscope_-_Wiley_Online_Library-6] “Rhinocerebral Mucormycosis: Evolution of the Disease and Treatment Options – Peterson – 1997 – The Laryngoscope – Wiley Online Library”.

[pmid8166512-7] Tedder M, Spratt JA, Anstadt MP, Hegde SS, Tedder SD, Lowe JE (1994). “Pulmonary mucormycosis: results of medical and surgical therapy”. Ann. Thorac. Surg. 57 (4): 1044–50. PMID 8166512.

[urlImproved_Outcome_of_Zygomycosis_in_Patients_with_Hematological_Diseases?:_Leukemia_&_Lymphoma:_Vol_45,_No_7-8] “Improved Outcome of Zygomycosis in Patients with Hematological Diseases?: Leukemia & Lymphoma: Vol 45, No 7”.

[urlCutaneous_Rhizopus_Infection_|_JAMA_|_The_JAMA_Network-9] _JAMA_|_The_JAMA_Network_9-0|↑ “Cutaneous Rhizopus Infection | JAMA | The JAMA Network”.

[urlGangrenous_Cutaneous_Mucormycosis_in_a_Child_with_a_Solid_Organ_Transplant:_A_Case_Report_and_Review_of_the_Literature_-_Boyd_-_2003_-_Pediatric_Dermatology_-_Wiley_Online_Library-10] “Gangrenous Cutaneous Mucormycosis in a Child with a Solid Organ Transplant: A Case Report and Review of the Literature – Boyd – 2003 – Pediatric Dermatology – Wiley Online Library”.

[urlwww.nature.com-11] “www.nature.com” (PDF).

[urlGASTRIC_PERFORATION_DUE_TO_MUCORMYCOSIS_AFTER_HEART-LUNG_AND..._:_Transplantation-12] “GASTRIC PERFORATION DUE TO MUCORMYCOSIS AFTER HEART-LUNG AND… : Transplantation”.

[urlZygomycosis_in_neutropenic_patients_with_past_Aspergillus_infection:_a_role_for_posaconazole?_-_Ide_-_2004_-_Clinical_Microbiology_and_Infection_-_Wiley_Online_Library-13] “Zygomycosis in neutropenic patients with past Aspergillus infection: a role for posaconazole? – Ide – 2004 – Clinical Microbiology and Infection – Wiley Online Library”.

[urlBreakthrough_Fungal_Infections_in_Stem_Cell_Transplant_Recipients_Receiving_Voriconazole_|_Clinical_Infectious_Diseases_|_Oxford_Academic-14] _Clinical_Infectious_Diseases_|_Oxford_Academic_14-0|↑ “Breakthrough Fungal Infections in Stem Cell Transplant Recipients Receiving Voriconazole | Clinical Infectious Diseases | Oxford Academic”.

[pmid13984484-15] STRAATSMA BR, ZIMMERMAN LE, GASS JD (1962). “Phycomycosis. A clinicopathologic study of fifty-one cases”. Lab. Invest. 11: 963–85. PMID 13984484.

[1]

_Clinical_Infectious_Diseases_|_Oxford_Academic-2|[2]

[3]

[4]

[5]

[6]

[7]

[8]

_JAMA_|_The_JAMA_Network-9|[9]

[10]

[11]

[12]

[13]

_Clinical_Infectious_Diseases_|_Oxford_Academic-14|[14]

[15]

Health Dictionary

Mucormycosis classification

Introduction

Overview

Classification

References