Fungi involved: Mucor, Rhizopus, Absidia, Rhizomucor (Order Mucorales, Class Zygomycetes)
High risk patients:
(1) solid organ transplantation
(2) prolonged, severe neutropenia
(3) hematopoietic stem cell transplantation, especially with corticosteroid therapy for a graft-vs-host reaction
(4) deferoxamine therapy
(5) prophylactic antifungal therapy (voriconazole, itraconazole, caspofungin)
Localized forms of mucormycosis at high risk for dissemination:
(1) cutaneous mucormycosis in a patient with extensive burns
(2) pulmonary mucormycosis with severe neutropenia
(3) gastrointestinal mucormycosis
Sites of infection:
(1) cerebral
(2) spleen
(3) heart
(4) skin
(5) other organs (depending how long the patient survives)
Clinical findings:
(1) usually a preceding focus of mucormycosis (rhinocerebral, pulmonary, etc)
(2) sudden onset of focal neurological deficits and/or coma
(3) severely ill with multi-organ dysfunction
Blood cultures are negative. Diagnosis often requires biopsy of infected tissue. A cutaneous lesion may be readily accessible.
