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Mucormycosis


Overview :

In the United States, mucormycosis is most likely to develop in the patient's nasal area or in the lungs; however, it may also develop on the skin or in the digestive tract. Gastrointestinal disease usually develops only in severely malnourished patients. Cutaneous mucormycosis is most likely to develop under occlusive surgical dressings. Occlusive dressings are intended to keep air out of incisions or other wounds, but they also trap body heat and moisture.

The incidence of the disease is difficult to evaluate because it is very rare; however, the rate seems to be increasing. One American cancer center reported in 2000 that mucormycosis was found in 0.7% of patients at autopsy and in 20 patients per 100,000 admissions to the center. The most recent mortality statistics from the Centers for Disease Control and Prevention (CDC) indicate that a total of 22 Americans died from mucormycosis in 2001'1 from pulmonary mucormycosis, 5 from rhinocerebral mucormycosis, 2 from disseminated mucormycosis, and 14 from unspecified forms of the disease.

As far as is known, mucormycosis affects members of either sex and all races equally, although the pulmonary form of the disease is somewhat more common in men than in women. Mucormycosis may develop in patients in any age group, including newborns.

Rhinocerebral mucormycosis

Rhinocerebral mucormycosis is an infection of the nose, eyes, and brain. The fungus destroys the tissue of the nasal passages, sinuses, or hard palate, producing a black or pus-filled discharge and visible patches of dying tissue. The patient will typically have fever, pain, and forward bulging of the eyes (proptosis). The fungus then invades the tissues around the eye socket and eventually the brain. At that point the patient may have convulsions or paralysis on one side of the body.

Pulmonary mucormycosis

Most patients with the pulmonary form of the disease are being treated for leukemia. The fungus enters the patient's lungs, where it eventually invades a major blood vessel, causing the patient to cough up blood or hemorrhage into the lungs.

Gastrointestinal mucormycosis

Gastrointestinal mucormycosis has been reported in premature or low-birth-weight infants as well as malnourished adults. It may lead to intestinal perforation and other complications requiring immediate surgery. A Spanish hospital reported in 2004 on an outbreak of gastrointestinal mucormycosis that affected five patients in an ICU over a 14-week period. Two of the patients died. The outbreak was eventually traced to a supply of wooden tongue depressors that had been contaminated by two species of Rhizopus fungi.




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