Summary
Definition
History and exam
Key diagnostic factors
- 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
Other diagnostic factors
- 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
Risk factors
- 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
Diagnostic tests
1st tests to order
- 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
Tests to consider
- broncoscopia com lavagem broncoalveolar e/ou cultura de fungos por biópsia transbrônquica
- histopatologia da biópsia
- microbiologia da biópsia
Emerging tests
- reação em cadeia da polimerase
Treatment algorithm
adequado para cirurgia
não adequado para cirurgia
falha do tratamento
Contributors
Authors
Rachana M. Palnitkar, MD
Infectious Diseases
Private Practice
Los Gatos
CA
Disclosures
RMP declares that she has no competing interests.
Michael Sands, MD, MPH & TM, FIDSA
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.
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
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.
Differentials
- Aspergilose
- Sinusite bacteriana
- Celulite periorbital bacteriana
More DifferentialsGuidelines
- Global guideline for the diagnosis and management of mucormycosis
More Guidelines
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