A rare infection caused by molds belonging to this subphylum Mucormycontina in the order Mucorales.

An invasive fungal infection.

These fungi are ubiquitous in nature.

Found particularly in soil, decaying wood, and other organic matter.

The most frequently encountered risk factors are immunosuppression, such as seen with cancer and diabetes, hematologic malignancies, hematopoietic stem cell transplant, solid organ transplantation, iron overload, and traumatic wound injuries.

It carries significant risk of morbidity and mortality in the setting of rhinocerebral, pulmonary, gastrointestinal, cutaneous, and disseminated infections.

Differentiating it initially from bacterial sinusitis is difficult in rhinocerebral infections.

Virtually all organs can be affected, but the sinuses and lungs are the most commonly involved.

Without early surgical management, rhino-cerebral  disease disease is progressive and rapid, resulting in sinorbital symptoms and extension to the CNS, resulting in death.

Have an affinity for iron rich environments, acidic environments and in iron overload states.

Classically associated with tissue necrosis due to vascular invasion and subsequent thrombosis.

Necrotic lesions occur because the fungus targets the vasculature.

Predominately affects immunocompromised patients.

Characterized by hyphae growing in and around vessels.

Fungal infection affects patients undergoing immunosuppressive therapy, have diabetes and hematologic malignancies.

Most common clinical presentation is rhinocerebral infection in diabetes.

Can manifest as superficial or deep infections.

Can appear as pustules, blisters, nodules, necrotic ulcerations, necrotic ulcerations echythema gangrenosum like lesions, or necrotizing cellulitis.

Intravascular thrombosis is a hallmark histological feature of cutaneous mucormycosis.

Platelet aggregation is induced by the interaction of fungal spores with plasma, IgG leading to immune complex formation.

Pulmonary infections are associated with cough, pleurodynia, hemoptysis, and shortness of breath.

Chest imaging may show annular consolidation central ground glass in opacity.

Biopsy is required for diagnosis, as cultures and fungal stains are not sensitive for diagnosis.

Cutaneous mucormycosis can occur in immunocompetent persons following trauma.

Occasionally cutaneous forms can disseminate to pulmonary involvement.

The leading cause of cancer related death worldwide.

Affected persons may present with perorbital infection, external ophthalmoplegia, visual loss as a result of vascular tissue structure destruction.

Mucormycosis originates in the nose or paranasal sinuses, but patients may have minimal sinus changes on x-ray studies.

When diagnosis is suspected patient should undergo immediate endoscopy of the nose and sinuses for necrotic tissue.

If diagnosis is suspected biopsy and culture should be performed and antifungal therapy started before test results return.

patient often fail antibiotic therapy before correct he still pathological diagnosis is made.

Diagnoses usually relies on direct microscopic observation or isolation of the fungus by culture from infected tissues.

There is no clinically useful biomarker to identify the disease and conventional diagnostic methods lack sensitivities.

New PCR techniques are promising for diagnosis.

Resection of local lesions and intravenous amphotericin B can prevent dissemination of cutaneous disease.

Management requires, usually, aggressive surgical debridement of the infected tissues.

timely surgical treatment and proper antifungal therapy are required to reduce the risk of mortality.Mucormycosis

First line antifungal treatment of mucormycosis consists of intravenous liposomal or a lipid complex amphotericin B formulation.

Posaconazole therapy is an effective one salvage therapy.

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