Mucormycosis physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]
Overview
Patients with mucormycosis usually appear lethargic, weak and debilitated owing to its development in immune compromised patients. Physical examination of patients with mucormycosis is usually remarkable for skin necrosis with a black eschar, fever, chills, myalgias, sore throat, non-productive cough, abdominal pain.
Physical Examination
General appearance of the patient
- Patients with mucormycosis usually appear weak and debilitated owing to its development in immune compromised individuals and patients with metabolic disorders.
Vital Signs
- High-grade fever
- Hypothermia/hyperthermia may be present in disseminated infection
- Tachycardia
- Tachypnea
- Kussmal respirations may be present in diabetic patients who develop mucormycosis on a background of diabetic ketoacidosis
- Weak pulse
- Hypotension, if condition leads to septic shock
Skin
Nasal and palatal findings
- Gray or erythematous appearance
- Can progress to black necrotic masses (ie, black eschar)
- Swelling
Ocular findings
- Proptosis
- Muddy sclera
- Conjunctival chemosis
- Ophthalmoplegia
- Fixed pupil
- Blindness
- Nystagmus
- Visual loss secondary to retinal artery thrombosis or direct fungal invasion
Neurologic findings
- Palsies of cranial nerves II, III, IV, V, VI, and VII
- Cerebral edema and vascular compromise may lead to coma and stroke
Pulmonary
- Sore throat
- Dyspnea on exertion
- Non-productive cough
- Crackles and rales on chest auscultation in pulmonary mucormycosis