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Mucormicose

Last reviewed: 18 Aug 2025
Last updated: 11 Apr 2025

Summary

Definition

História e exame físico

Principais fatores diagnósticos

  • presença de fatores de risco
  • dor facial e no seio nasal
  • dor nos olhos, visão turva
  • proptose
  • paralisia de nervo craniano
  • tosse seca, com ou sem dispneia
  • nódulos cutâneos
Detalhes completos

Outros fatores diagnósticos

  • febre
  • celulite periorbital
  • secreção nasal viscosa, com coloração marrom escura-negra
  • deficits neurológicos motores/sensoriais focais e estado mental alterado
  • escara necrótica
  • hemoptise
  • dor e distensão abdominal
  • hemorragia digestiva
  • peritonite
Detalhes completos

Fatores de risco

  • diabetes mellitus ± cetoacidose diabética
  • neoplasia hematológica
  • neutropenia
  • sobrecarga de ferro ou uso de desferroxamina
  • uso de corticosteroides
  • transplantes hematopoéticos e de órgão sólido, doença do enxerto contra o hospedeiro
  • decomposição cutânea e de tecidos moles
  • desnutrição
  • prematuridade
  • cirrose hepática
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • Hemograma completo
  • perfil metabólico básico
  • gasometria arterial
  • urinálise
  • nível sérico de corpos cetônicos
  • tomografia computadorizada (TC) dos seios nasais e do cérebro
  • ressonância nuclear magnética (RNM) dos seios nasais e do cérebro
  • TC do tórax com contraste
  • endoscopia nasal
  • endoscopia digestiva
Detalhes completos

Investigações a serem consideradas

  • broncoscopia com lavagem broncoalveolar e/ou cultura de fungos por biópsia transbrônquica
  • histopatologia da biópsia
  • microbiologia da biópsia
Detalhes completos

Novos exames

  • reação em cadeia da polimerase

Algoritmo de tratamento

AGUDA

adequado para cirurgia

não adequado para cirurgia

CONTÍNUA

falha do tratamento

Colaboradores

Autores

Rachana M. Palnitkar, MD
Rachana M. Palnitkar

Infectious Diseases

Private Practice

Los Gatos

CA

Declarações

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

Declarações

MS declares that he has no competing interests.

Revisores

Michail Lionakis, MD, ScD

Infectious Diseases Fellow

Laboratory of Molecular Immunology

National Institute of Allergy and Infectious Diseases

NIH

Bethesda

MD

Declarações

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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

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

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