Zygomycoses

Collection of life-threatening fungal infections caused by:

Epidemiology and Risk Factors

Mucormycosis:

  • 3rd most common disease of stem-cell transplants
  • ↑ Incidence

Pathophysiology

Aetiology

Clinical Manifestations

Generally non-specific:

  • Local inflammation
    • Generally sinusitis as sinus infection common
  • Progression to more extensive local invasion with:
    • Cellulitis
      • Black eschar over skin
    • Pneumonia
    • Cerebral invasion
      • Cranial nerve signs

Diagnostic Approach and DDx

Investigations

Bedside:

Laboratory:

  • Culture
    • Generally 3-5 days to positivity
  • Tissue or abscess samples
    • Periodic acid-Schiff staining
    • Grocott’s methenamine silver dry-mount staining

Imaging:

Other:

Management

Resuscitation:

Specific therapy:

  • Pharmacological
    • Antifungals
      • Amphotericin B
  • Procedural
  • Physical

Supportive care:

Disposition:

Preventative:

Marginal and Ineffective Therapies

Anaesthetic Considerations

Complications

Prognosis

Key Studies


References