Mucormycosis

Background

1. Infection of fungal hyphae in immunocompromised hosts
   1. DM
   2. HIV
   3. Neutropenic

Locations

1. Most commonly affects paranasal sinuses (rhinocerebral mucormycosis)
2. Pulmonary
3. GI
4. CNS

Diagnosis

Rhinocerebral: mimics acute bacterial sinusitis, however a much more rapid, extensive expansion of the fungus to the surrounding anatomy is classic

Can spread to orbits, oropharynx, nasopharynx, brain, nearby vasculature leading to:

1. Vision changes
2. Nasopharyngeal and oropharyngeal ulceration or eschars
3. Facial edema, pain
4. Cranial nerve deficits
5. Headache

Workup

CT scan of sinuses

Treatment

1. Adjunctive: Amphotericin B (1mgkg/d IV)
2. Definitive: Prompt surgical consultation --> debridement

Prognosis

Mortality 30-90%