ABSTRACT
Mucormycosis (formerly zygomycosis) is a life-threatening opportunistic mycosis that
infects a broad range of hosts with qualitative or quantitative defects in innate
immunity, including patients with severe neutropenia, recipients of corticosteroids
or other immunosuppressive medications, poorly controlled diabetes mellitus, and those
with iron overload states. Mucormycosis has recently emerged as breakthrough sinopulmonary
infection in hematologic patients and recipients of transplantation being on antifungal
prophylaxis with Aspergillus-active antifungals that lack activity against Mucorales. Unlike pulmonary aspergillosis, the prognosis and outcome of pulmonary mucormycosis
have not improved significantly over the last decade, mainly because of difficulties
in early diagnosis and the limited activity of current antifungal agents against Mucorales. Recent evidence suggests a critical role for iron metabolism and fungal–endothelial
cell interactions in pathogenesis of mucormycosis, and holds promise for development
of novel therapeutic strategies. Currently, prompt initiation of antifungal therapy
with a lipid amphotericin B–based regimen, reversal of underlying host factors, and
aggressive surgical approach offers the best chances for survival of patients infected
with this devastating mycosis.
KEYWORDS
Mucormycosis - zygomycosis -
Rhizopus
-
Mucor
- immunocompromised - hematologic malignancy
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Dimitrios P. KontoyiannisM.D.
Department of Infectious Diseases, Infection Control and Employee Health, Unit 402,
The University of Texas MD Anderson Cancer Center
1515 Holcombe Blvd., Houston, TX 77030
eMail: dkontoyi@mdanderson.org
