Novel Perspectives on Mucormycosis: Pathophysiology, Presentation, and Management

Novel Perspectives on Mucormycosis: Pathophysiology, Presentation, and Management

July 2005 | Brad Spellberg, John Edwards, Jr., and Ashraf Ibrahim
The article provides a comprehensive overview of mucormycosis, a life-threatening fungal infection primarily affecting immunocompromised individuals. The zygomycetes, including the Mucorales and Entomophthorales orders, are the causative agents. Mucorales, particularly the family Mucoraceae, are the most common causes of mucormycosis, with *Rhizopus oryzae* being the most frequently isolated species. The pathogenesis involves the fungus's ability to scavenge iron, evade host defenses, and access blood vessels for dissemination. Iron chelators like deferoxamine have been identified as risk factors for mucormycosis, as they enhance iron availability and fungal growth. The clinical presentation of mucormycosis varies, with rhinocerebral, pulmonary, cutaneous, gastrointestinal, disseminated, and miscellaneous forms being the most common categories. Early diagnosis and treatment are critical, involving surgical debridement and antifungal therapy. Liposomal amphotericin B is recommended as the first-line treatment due to its superior efficacy compared to amphotericin B deoxycholate. Azoles and echinocandins are also used, but their effectiveness varies. The article highlights the need for further research and the potential of novel antifungal agents to improve outcomes in mucormycosis.The article provides a comprehensive overview of mucormycosis, a life-threatening fungal infection primarily affecting immunocompromised individuals. The zygomycetes, including the Mucorales and Entomophthorales orders, are the causative agents. Mucorales, particularly the family Mucoraceae, are the most common causes of mucormycosis, with *Rhizopus oryzae* being the most frequently isolated species. The pathogenesis involves the fungus's ability to scavenge iron, evade host defenses, and access blood vessels for dissemination. Iron chelators like deferoxamine have been identified as risk factors for mucormycosis, as they enhance iron availability and fungal growth. The clinical presentation of mucormycosis varies, with rhinocerebral, pulmonary, cutaneous, gastrointestinal, disseminated, and miscellaneous forms being the most common categories. Early diagnosis and treatment are critical, involving surgical debridement and antifungal therapy. Liposomal amphotericin B is recommended as the first-line treatment due to its superior efficacy compared to amphotericin B deoxycholate. Azoles and echinocandins are also used, but their effectiveness varies. The article highlights the need for further research and the potential of novel antifungal agents to improve outcomes in mucormycosis.
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Understanding Novel Perspectives on Mucormycosis%3A Pathophysiology%2C Presentation%2C and Management