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Revision as of 20:17, 2 October 2012

Zygomycosis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

History and symptoms

Mucormycosis frequently involves the sinuses, brain, or lungs as the sites of infection. Whilst orbitorhinocerebral mucormycosis is the most common type of the disease, this infection can also manifest in the gastrointestinal tract, skin, and in other organ systems.[1] The clinical hallmark of mucormycosis is vascular invasion resulting in thrombosis and tissue infarction/necrosis.[2]

If rhinocerebral disease is the cause of the infection, symptoms may include unilateral, retro-orbital headache, facial pain, fevers, nasal stuffiness that progresses to black discharge, acute sinusitis, and eye swelling along with protrusion of eye orbit.[3] In addition, affected skin may appear relatively normal during the earliest stages of infection. This skin quickly progresses to an erythemic (reddening, occasionally with edema) stage, before eventually turning black due to necrosis.[2] However, in other forms of mucormycosis (such as pulmonary, cutaneous or disseminated mucormycosis), symptoms may also include dyspnea, persistent cough, hemoptysis (in cases of necrosis and nausea/vomiting), coughing blood, and abdominal pain..[1][3]

Rarely, maxilla may be affected by mucormycosis.[4] The lack of case reports regarding maxillofacial mucormycosis lies in the rich vascularity of the maxillofacial areas preventing fungal infections, although this can be overcome by more prevalent fungi, bacteria or viruses such as those responsible for mucormycosis.[4]

Predisposing factors for mucormycosis include AIDS, malignancies such as lymphomas and leukemias, renal failure, organ transplant, long term corticosteroid and immunosuppressive therapy, cirrhosis, burns and energy malnutrition.[4]

Possible complications of mucormycosis include the partial loss of neurological function, blindness and clotting of brain or lung vessels.[3]

Basidiobolomycosis is usually a superficial infection of skin, but may very rarely cause lesions of the bowel or liver, mimicking bowel cancer,[5] or Crohn's disease.[6] In patients with deep involvement, the eosinophil count may be raised, falsely suggesting a parasitic infection.

References

  1. 1.0 1.1
  2. 2.0 2.1 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. PMID 16020690. PMC 1195964
  3. 3.0 3.1 3.2
  4. 4.0 4.1 4.2
  5. Van den berk GEL, Noorduyn LA, van Ketel RJ; et al. (2006). "A fatal pseudo-tumour: disseminated basidiobolomycosis". BMC Infect Dis. 6: 140. doi:10.1186/1471-2334-6-140.
  6. Zavasky DM, Samowitz W, Loftus T, Segal H, Carroll K (1999). "Gastrointestinal zygomycotic infection caused by Basidiobolus ranarum: case report and review". Clin Infect Dis. 28 (6): 1244&ndash, 8.


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