Mucormycosis: Types, Symptoms, Treatment & More
Mucormycosis (previously called zygomycosis) is a serious but rare fungal infection caused by a group of molds called mucormycetes. These molds live throughout the environment.
Mucormycosis mainly affects people who have health problems or take medicines that lower the body’s ability to fight germs and sickness. It most commonly affects the sinuses or the lungs after inhaling fungal spores from the air. It can also develop on the skin after the fungus enters the skin through a cut, scrape, burn, or other type of skin trauma.
Who Is At Risk?
People with a weakened immune system are more likely to develop mucormycosis. Other risk factors include:
- Diabetes mellitus, especially with diabetic ketoacidosis
- Long-term corticosteroid use
- Organ or stem cell transplants
- Excess iron in the body
- Injection drug use
- Treatment with deferoxamine
- Low white blood cell count (neutropenia)
- Prematurity birth/low birth weight
It's also more likely if you have a skin injury like a burn, cut, or wound. And cases have been reported in people with COVID-19.
Types of Mucormycosis
Rhinocerebral (sinus and brain) mucormycosis is an infection in the sinuses that can spread to the brain. This form of mucormycosis is most common in people with uncontrolled diabetes and in people who have had a kidney transplant.
Pulmonary (lung) mucormycosis is the most common type of mucormycosis in people with cancer and in people who have had an organ transplant or a stem cell transplant.
Gastrointestinal mucormycosis is more common among young children than adults, especially premature and low birth weight infants less than 1 month of age, who have had antibiotics, surgery, or medications that lower the body’s ability to fight germs and sickness.
Cutaneous (skin) mucormycosis occurs after the fungi enter the body through a break in the skin (for example, after surgery, a burn, or other type of skin trauma). This is the most common form of mucormycosis among people who have weakened immune systems.
Disseminated mucormycosis occurs when the infection spreads through the bloodstream to affect another part of the body. The infection most commonly affects the brain, but also can affect other organs such as the spleen, heart, and skin.
Symptoms of Mucormycosis
The symptoms of mucormycosis depend on type and where in the body the fungus is growing.
Symptoms of rhinocerebral (sinus and brain) mucormycosis include:
- One-sided facial swelling
- Nasal or sinus congestion
- Black lesions on nasal bridge or upper inside of mouth that quickly become more severe
Symptoms of pulmonary (lung) mucormycosis include:
- Chest pain
- Shortness of breath
- Excessive redness or swelling around a wound
Symptoms of gastrointestinal mucormycosis include:
- Abdominal pain
- Nausea and vomiting
- Gastrointestinal bleeding
Disseminated mucormycosis typically occurs in people who are already sick from other medical conditions, so it can be difficult to know which symptoms are related to mucormycosis. Patients with disseminated infection in the brain can develop mental status changes or coma.
How is Mucormycosis Diagnosed?
Healthcare providers consider your medical history, symptoms, physical examinations, and laboratory tests when diagnosing mucormycosis.
Healthcare providers who suspect that you have mucormycosis in your lungs or sinuses might collect a sample of fluid from your respiratory system to send to a laboratory.
Your healthcare provider may perform a tissue biopsy, in which a small sample of affected tissue is analyzed in a laboratory for evidence of mucormycosis under a microscope or in a fungal culture.
You may also need imaging tests such as a CT scan of your lungs, sinuses, or other parts of your body, depending on the location of the suspected infection.
How is Mucormycosis Treated?
Mucormycosis is a serious infection and needs to be treated with prescription antifungal medicine, usually amphotericin B, posaconazole, or isavuconazole. These medicines are given through a vein (amphotericin B, posaconazole, isavuconazole) or by mouth (posaconazole, isavuconazole). Other medicines, including fluconazole, voriconazole, and echinocandins, do not work against fungi that cause mucormycosis. Often, mucormycosis requires surgery to cut away the infected tissue.
Complications of Mucormycosis
Complications of mucormycosis include:
- Blindness (if the optic nerve is involved)
- Clotting or blockage of brain or lung blood vessels
- Nerve damage
Prevention of Mucormycosis
- Control your blood sugar levels
- Use steroids judiciously
- Avoid construction areas or places with a lot of dust
- Clean cuts and other skin injuries well with soap and water, especially when exposed to soil or dust
- Use clear, sterile water
- Wash face masks regularly
- Maintain good hygiene
If you are at high risk of developing mucormycosis, a medical professional may prescribe antifungal medication for prevention of mucormycosis and other mold infections.