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Mucormycosis

Aggressive angioinvasive fungal infection caused by Mucorales (Rhizopus, Mucor, Lichtheimia, Cunninghamella) presenting as rhino-orbital-cerebral, pulmonary, cutaneous, or disseminated disease in diabetics with ketoacidosis and immunocompromised hosts; requires urgent surgical debridement and antifungal therapy with liposomal amphotericin B.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Internal Medicine department. Book Appointment →

What is Mucormycosis?

Mucormycosis is caused by ubiquitous environmental fungi of order Mucorales (Rhizopus oryzae most common, also Mucor, Lichtheimia, Cunninghamella, Apophysomyces, Saksenaea) found in soil, decaying vegetation, and contaminated water. These thermotolerant filamentous fungi enter through inhalation, ingestion, or direct skin inoculation, exhibiting strong angioinvasion causing tissue infarction, hemorrhage, and necrosis with characteristic black eschar formation.

Clinical forms include rhino-orbital-cerebral mucormycosis (most common in diabetics with DKA, presents with facial pain, black palatal eschar, ophthalmoplegia, vision loss, intracranial extension), pulmonary mucormycosis (in hematologic malignancy/transplant, cavitation, hemoptysis, halo and reverse halo signs), cutaneous mucormycosis (post-trauma, post-burn, contaminated dressings, necrotizing fasciitis-like), gastrointestinal (rare, premature infants), and disseminated forms.

Treatment requires emergency surgical debridement of all necrotic tissue (multiple sessions often needed), high-dose liposomal amphotericin B (5-10 mg/kg/day), reversal of underlying conditions (DKA correction, reduce immunosuppression, treat neutropenia), and adjunctive therapy with isavuconazole or posaconazole. Mortality remains 50-90% despite aggressive treatment; key factors are early recognition, prompt surgery, and amphotericin B initiation. Recently elevated profile due to COVID-19-associated mucormycosis (CAM) in India and other countries with extensive corticosteroid use.

Symptoms

Facial pain, swelling, periorbital edema
Black eschar on palate or nasal mucosa (pathognomonic)
Ophthalmoplegia, vision loss, proptosis
Severe headache, altered mental status (CNS extension)
Pulmonary symptoms: cough, hemoptysis, pleuritic pain
Necrotizing skin lesions with black eschars
Fever, sepsis in disseminated disease

Risk Factors

Diabetes mellitus with diabetic ketoacidosis
Hematologic malignancies with prolonged neutropenia
Hematopoietic stem cell or solid organ transplantation
Prolonged corticosteroid therapy
Iron overload (deferoxamine therapy historically)
Severe burns or major trauma
COVID-19 with steroid treatment (CAM, particularly described in India)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Facial pain or swelling in diabetic with poor control
  • Black palatal or nasal lesion
  • Sudden vision loss or ophthalmoplegia
  • Pulmonary symptoms in immunocompromised host
  • Necrotizing skin lesion in immunocompromised patient
  • Cavitating pulmonary lesion in neutropenic patient
  • Suspected fungal infection in DKA

Treatment Methods

01
Emergency surgical debridement of all necrotic tissue (often staged)
02
High-dose liposomal amphotericin B 5-10 mg/kg/day intravenously
03
Reversal of underlying conditions (DKA correction, reduce immunosuppression)
04
Isavuconazole or posaconazole as alternative or step-down therapy
05
G-CSF for neutropenic patients
06
Hyperbaric oxygen therapy as adjunct in selected cases
07
Multidisciplinary team (ID, ENT, ophthalmology, neurosurgery, endocrinology)

Which Department to Visit?

You can visit our Enfeksiyon Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Enfeksiyon Hastalıkları Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.