Mucormycosis: what it is, symptoms and treatment

Mucormycosis, formerly known as zygomycosis, is a term used to refer to a group of infections caused by fungi of the order Mucorales, most commonly by the fungus Rhizopus spp . These infections are not transmitted from one person to another and are more frequent in people with low immunity or uncontrolled diabetes.

The disease happens when the fungi are inhaled, going directly to the lungs, or when they enter the body through a cut in the skin, leading to the appearance of symptoms according to the organ that was infected, and there may be severe headache, fever, swelling, redness in the face and intense discharge from the eyes and nose. When mucormycosis reaches the brain, seizures, speech difficulties and even loss of consciousness can occur.

The diagnosis of mucormycosis is made by a general practitioner or infectious disease using computed tomography and fungal culture and treatment is usually done using injectable or oral antifungal drugs, such as Amphotericin B.

Main signs and symptoms

The signs and symptoms of mucormycosis can vary according to the degree of immunocompromise of the person and organ affected by the fungus, and there may be:

• Nose: it is one of the organs most affected by this disease and leads to the appearance of symptoms similar to sinusitis, such as stuffy nose, pain in the cheeks and greenish phlegm, but in the most severe cases, swelling in the face, loss of tissue the roof of the mouth or the cartilage of the nose; Eyes: the manifestations of mucormycosis can be observed through problems in vision such as difficulty in seeing, accumulation of yellow discharge and swelling around the eyes; Lungs: when fungi reach this organ, there may be coughing with large production of phlegm or blood, chest pain and difficulty in breathing; Brain: this organ is affected when mucormycosis spreads and can cause symptoms such as seizures, difficulty speaking, changes in facial nerves and even loss of consciousness; Skin: Mucormycosis fungi can infect regions of the skin, and red, hardened, swollen, painful lesions may appear and, in some situations, can become blisters and form open, black-looking wounds.

In more advanced cases, the person with mucormycosis may have a bluish tinge on the skin and purple fingers and this is due to the lack of oxygen caused by the accumulation of fungi in the lungs. In addition, if the infection is not identified and treated, the fungus can spread quickly to other organs, especially if the person has a very compromised immune system, reaching the kidneys and heart and putting the person's life at risk.

Types of mucormycosis

Mucormycosis can be divided into several types according to the location of the fungal infection, and can be:

• Rhinocerebral mucormycosis, which is the most common form of the disease, and most of these cases occur in people with decompensated diabetes. In this type, fungi infect the nose, sinuses, eyes and mouth; Pulmonary mucormycosis, in which fungi reach the lungs, this being the second most common manifestation; Cutaneous mucormycosis, which consists of the spread of fungal infection in parts of the skin, which can even reach the muscles; Gastrointestinal mucormycosis, in which the fungus reaches the gastrointestinal tract, being more rare to happen.

There is also a type of mucormycosis, called disseminated, which is more rare and occurs when fungi migrate to various organs in the body, such as the heart, kidneys and brain.

Possible causes

Mucormycosis is a group of infections caused by fungi of the order Mucorales, the most common being Rhizopus spp. , which are found in various places in the environment, such as vegetation, soil, fruits and decomposing products.

Usually, these fungi do not cause health problems, as they can be fought by the immune system. The development of diseases occurs mainly in people who have a compromised immune system, being more frequent in people with decompensated diabetes. In addition, people with low immunity due to diseases such as HIV, use of immunosuppressive drugs or some type of transplant, such as bone marrow or organs, are also at increased risk of developing mucormycosis.

How the diagnosis is made

The diagnosis of mucormycosis is made by a general practitioner or infectious disease by assessing the person's health history and computed tomography, which serves to verify the location and extent of the infection. Sputum culture is also performed, which is based on analyzing lung secretions to identify the infection-related fungus.

In some cases, the doctor may also request a molecular examination, such as PCR, to identify the species of fungus and, depending on the technique used, the amount present in the organism, and MRI to investigate whether the mucormycosis has reached the structures of the brain, for example. These tests should be done as soon as possible, because the faster the diagnosis is made, the more chances are there to eliminate the infection.

Mucormycosis treatment

The treatment for mucormycosis should be done quickly, as soon as the disease is diagnosed, so that the chances of cure are greater and should be done according to the doctor's recommendation, and the use of antifungals directly in the vein, such as Amphotericin, may be indicated. B, or Posaconazole, for example. It is important that the medicines are used according to the medical recommendation and that the treatment is stopped even if there are no more symptoms.

In addition, depending on the severity of the infection, the doctor may recommend surgery to remove the necrotic tissue caused by the fungus, which is called debridement. Hyperbaric chamber therapy may also be recommended, however, there are not yet enough studies to prove its effectiveness. Learn more about how the hyperbaric chamber works.