Zygomycosis May Pose Threat to Bone Marrow Recipients

[Guest guest]

Zygomycosis: An Emerging Fungal Infection

Abstract

Purpose: The epidemiology, pathogenesis, clinical presentation and

diagnosis, and management of zygomycosis are reviewed.

Summary: The frequency of zygomycosis has been increasing over the

past 10 years; infections have been identified in up to 6.8% of

patients at autopsy. The most common route of transmission for

Zygomycetes fungi is inhalation of spores from the environment.

Patients at highest risk for infections caused by Mucorales fungi

include those with profound immunosuppression or diabetes,

intravenous drug abusers, premature infants, those receiving

deferoxamine, and recipients of bone marrow transplants. Mucormycosis

commonly presents as rhinocerebral or pulmonary disease;

gastrointestinal presentations also occur. Clinical manifestations of

invasive mucormycosis are tissue necrosis and subsequent thrombosis.

Common features of pulmonary disease include fever, dyspnea,

hemoptysis, and cavitation upon radiologic examination. The mainstays

of treatment are control or reversal of the underlying disease or

immunosuppression, antifungal therapy, and aggressive surgical

debridement. Posaconazole, a new triazole antifungal, has been used

successfully in a number of cases that did not respond to

amphotericin B.

Conclusion: Zygomycosis appears to be on the rise in the United

States. The standard treatment is a combination of amphotericin B

therapy, surgical debridement, and reversal of the underlying disease

or immunosuppression.

http://www.medscape.com/viewarticle/519714?src=mp (free registration

may be necessary)