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Mucormycosis

Last reviewed: 7 Apr 2025
Last updated: 11 Apr 2025

Summary

Definition

History and exam

Key diagnostic factors

  • sinus and facial pain
  • eye pain, blurred vision
  • proptosis
  • cranial nerve palsies
  • dry cough, with or without dyspnea
  • skin nodules
Full details

Other diagnostic factors

  • fever
  • periorbital cellulitis
  • viscid, dark brown-black nasal discharge
  • focal sensory/motor neurologic deficits and altered mental status
  • necrotic eschar
  • hemoptysis
  • abdominal pain and distension
  • gastrointestinal bleeding
  • peritonitis
Full details

Risk factors

  • diabetes mellitus ± diabetic ketoacidosis
  • hematologic malignancy
  • neutropenia
  • iron overload or use of deferoxamine
  • use of corticosteroids
  • hematopoietic and solid organ transplantation, graft-versus-host disease
  • breakdown of skin and soft tissue
  • malnutrition
  • prematurity
  • liver cirrhosis
Full details

Diagnostic tests

1st tests to order

  • CBC
  • basic metabolic profile
  • ABG
  • urinalysis
  • serum ketone level
  • CT sinuses and brain
  • MRI sinuses and brain
  • CT chest with contrast
  • nasal endoscopy
  • gastrointestinal endoscopy
Full details

Tests to consider

  • bronchoscopy with bronchoalveolar lavage and/or transbronchial biopsy fungal culture
  • histopathology of biopsy
  • microbiology of biopsy
Full details

Emerging tests

  • polymerase chain reaction (PCR)

Treatment algorithm

ACUTE

suitable for surgery

unsuitable for surgery

ONGOING

treatment failure

Contributors

Authors

Rachana M. Palnitkar, MD
Rachana M. Palnitkar

Infectious Diseases

Private Practice

Los Gatos

CA

Disclosures

RMP declares that she has no competing interests.

Michael Sands, MD, MPH & TM, FIDSA
Michael Sands

Professor of Medicine

College of Medicine

University of Florida

Jacksonville

FL

Disclosures

MS declares that he has no competing interests.

Peer reviewers

Michail Lionakis, MD, ScD

Infectious Diseases Fellow

Laboratory of Molecular Immunology

National Institute of Allergy and Infectious Diseases

NIH

Bethesda

MD

Disclosures

ML declares that he has no competing interests.

Rachael Morris-Jones, PhD, FRCP, PCME

Dermatology Consultant and Honorary Senior Lecturer

Kings College Hospital

London

UK

Disclosures

RMJ declares that she has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Pham D, Howard-Jones AR, Sparks R, et al. Epidemiology, modern diagnostics, and the management of mucorales infections. J Fungi (Basel). 2023 Jun 12;9(6):659.Full text  Abstract

Spellberg B, Edwards J Jr, Ibrahim A. Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev. 2005 Jul;18(3):556-69.Full text  Abstract

Centers for Disease Control and Prevention. Mucormycosis: clinical overview of mucormycosis. Apr 2024 [internet publication].Full text

Cornely OA, Alastruey-Izquierdo A, Arenz D, et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis. 2019 Dec;19(12):e405-21.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Mucormycosis images
  • Differentials

    • Aspergillosis
    • Bacterial sinusitis
    • Bacterial periorbital cellulitis
    More Differentials
  • Guidelines

    • Global guideline for the diagnosis and management of mucormycosis
    • Global guideline for the diagnosis and management of mucormycosis
    More Guidelines
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