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

Clinical Features

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

Diagnostic Evaluation

• Can be clinical diagnosis
• CT scan of sinuses with IV contrast can assist with diagnosis

Management

• Emergent ENT consult for OR debridement (definitive treatment)
• Start Amphotericin B 1mg/kg IV
• Aggressive resuscitation, airway management, and supportive care while in ED.

Prognosis

Mortality 30-90%

See Also

• Fungal Infections