Fungi involved: Mucor, Rhizopus, Absidia, Rhizomucor (Order Mucorales, Class Zygomycetes)
The route of infection may involve:
(1) inhalation
(2) hematogenous spread
(3) lymphatic spread
High risk patients:
(1) severe neutropenia, especially after chemotherapy for leukemia
(2) hematopoietic stem cell transplantation, especially in patients with graft-vs-host disease treated with corticosteroids
(3) diabetic ketoacidosis
Clinical findings:
(1) cough
(2) dyspnea, progressing to respiratory failure
(3) chest pain
(4) fever
Complications associated with high mortality:
(1) disseminated fungal infection
(2) angioinvasion with thrombosis, necrosis, cavitation and hemoptysis
Radiographic patterns:
(1) lobar consolidation
(2) isolated masses
(3) nodular disease
(4) cavitation
(5) wedge-shaped infarcts
Diagnosis usually requires biopsy of infected tissue taken either at surgery or during bronchoscopy. Sputum and bronchoalveolar lavage cultures are usually negative.
