Mucormycosis

Question 1

Risk factors for mucormycosis?

Answer 1

DM2 with DKA
hematological malignancy
solid organ or stem cell transplant
chronic steroid use
HIV/AIDs
Iron overload and chelation therapy with deferoxamine

Question 2

Clinical presentation of mucormycosis

Answer 2

rhino-orbital-cerebral presentation which is most common
-see acute sinusitis in all sinuses with rapid local extension
periorbital edema proptosis and blindness
cavernous sinus disease with cranial nerve palsies thrombosis of the sinus and carotid artery involvement

Pulmonary presentation with pneumonia and hemoptysis and necrosis

GI - see pertionitis

skin painful indurated cellulitis

Question 3

what is mucormycosis?

Answer 3

devastating mold infection - part of the mucorales species and seen in soil and decaying vegetable matter.

Question 4

why is mucormycosis so bad?

Answer 4

because it causes angioinvasion leadign to tissue infarction and infection begins in the nasal turbinates through spore inhalation and pts present with acute sinusitis, fever, sinus pain, and purulent nasal discharge and congestion.

Dx progresses rapidly as pts develop symptoms of invasion into the eye structures and brain

Question 5

what is seen on CT imaging of the mucormycosis?

Answer 5

see edematous mucosa and destruction of the facial bone and periorbital tissues

Question 6

diagnosis of mucormycosis is by:

Answer 6

biopsy and tissue examination that shows hyphae with irregular branching without septations

Question 7

how does aspergillus look different mucormycosis on exam?

Answer 7

aspergillus has regular branching and many septations

seen in immunocompromised pts

Question 8

Treatment of mucormycosis is

Answer 8

IV amphotercin B and surgical debridement