Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- sinus and facial pain
- eye pain, blurred vision
- proptosis
- cranial nerve palsies
- dry cough, with or without dyspnoea
- skin nodules
Other diagnostic factors
- fever
- peri-orbital cellulitis
- viscid, dark brown-black nasal discharge
- focal sensory/motor neurological deficits and altered mental status
- necrotic eschar
- haemoptysis
- abdominal pain and distension
- gastrointestinal bleeding
- peritonitis
Risk factors
- diabetes mellitus ± diabetic ketoacidosis
- haematological malignancy
- neutropenia
- iron overload or use of desferrioxamine
- use of corticosteroids
- haematopoietic and solid organ transplantation, graft-versus-host disease
- breakdown of skin and soft tissue
- malnutrition
- prematurity
- liver cirrhosis
Diagnostic tests
1st tests to order
- FBC
- basic metabolic profile
- ABG
- urinalysis
- serum ketone level
- CT sinuses and brain
- MRI sinuses and brain
- CT chest with contrast
- nasal endoscopy
- gastrointestinal endoscopy
Tests to consider
- bronchoscopy with bronchoalveolar lavage and/or trans-bronchial biopsy fungal culture
- histopathology of biopsy
- microbiology of biopsy
Emerging tests
- polymerase chain reaction (PCR)
Treatment algorithm
suitable for surgery
unsuitable for surgery
treatment failure
Contributors
Autores
Rachana M. Palnitkar, MD
Infectious Diseases
Private Practice
Los Gatos
CA
Declarações
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
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
Declarações
RMJ declares that she has no competing interests.
Créditos aos pareceristas
Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.
Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
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.Texto completo Resumo
Spellberg B, Edwards J Jr, Ibrahim A. Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev. 2005 Jul;18(3):556-69.Texto completo Resumo
Centers for Disease Control and Prevention. Mucormycosis: clinical overview of mucormycosis. Apr 2024 [internet publication].Texto completo
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.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Aspergillosis
- Bacterial sinusitis
- Bacterial peri-orbital cellulitis
Mais Diagnósticos diferenciaisDiretrizes
- Global guideline for the diagnosis and management of mucormycosis
Mais Diretrizes
Conectar-se ou assinar para acessar todo o BMJ Best Practice
O uso deste conteúdo está sujeito ao nosso aviso legal