Mucormycosis natural history, complications and prognosis

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Mucormycosis Microchapters

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Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Mucormycosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]

Overview

In most cases, the prognosis of mucormycosis is poor and has varied mortality rates depending on its form and severity. In the rhinocerebral form, the mortality rate is between 30% and 70%, whereas disseminated mucormycosis presents with the highest mortality rate in an otherwise healthy patient, with a mortality rate of up to 100%. Patients with AIDS have a mortality rate of almost 100%. Possible complications of mucormycosis include the partial loss of neurological function, blindness and clotting of brain or lung vessels.

Natural History[1]

If left untreated, mucormycosis can be fatal. The survival rate of immunosuppressed patients with rhino sinusal mucormycosis without cerebral involvement is between 50-80%, and only 10% if the infection spreads into the brain. In uncontrolled diabetes mellitus patients with ketoacidosis, who are diagnosed with rhino-orbital mucormycosis, cerebral spread of infection should be suspected, if there is no improvement after 24 hours since the beginning of treatment. In 70% of cases mucormycosis occurs in diabetics, and the percentage increases if there is concomitant immunosupression and comorbities.

Complications[2]

Prognosis[3]

References

  1. Nicolae M, Popescu CR, Popescu B, Grigore R (2013). "Orbital complications of fungal pan-sinusitis in uncontrolled diabetes". Maedica (Buchar). 8 (3): 276–9. PMC 3869119. PMID 24371499.
  2. Dhooria S, Agarwal R, Chakrabarti A (2015). "Mediastinitis and Bronchial Perforations Due to Mucormycosis". J Bronchology Interv Pulmonol. 22 (4): 338–42. doi:10.1097/LBR.0000000000000170. PMID 26348693.
  3. Parfrey NA (1986). "Improved diagnosis and prognosis of mucormycosis. A clinicopathologic study of 33 cases". Medicine (Baltimore). 65 (2): 113–23. PMID 3951358.
  4. Marr KA, Carter RA, Crippa F, Wald A, Corey L (2002). "Epidemiology and outcome of mould infections in hematopoietic stem cell transplant recipients". Clin. Infect. Dis. 34 (7): 909–17. doi:10.1086/339202. PMID 11880955.
  5. Spellberg B, Edwards J, Ibrahim A (2005). "Novel perspectives on mucormycosis: pathophysiology, presentation, and management". Clin. Microbiol. Rev. 18 (3): 556–69. doi:10.1128/CMR.18.3.556-569.2005. PMC 1195964. PMID 16020690.



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