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A 55-year-old male with diabetes mellitus is admitted with a severe infection of his face. The patient has a very high fever, is in septic shock, and the entire right face appears necrotic. What is the most likely organism?
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Teaching Points
- Mucormycosis is caused by Mucorales fungi, an opportunistic fungus. The fungi commonly infect persons with diabetes mellitus or individuals who are immunosuppressed.
- Mucorales fungi have great potential to invade the local tissues and cause rapid fulminating of the surrounding tissue.
- On microscopy, the fungus is broad-based and has a right-angle appearance. Most patients have a poor prognosis after acquiring mucormycosis.
- Mucormycosis is characterized by hyphae growing around blood vessels and can be life-threatening in patients with diabetes mellitus or those who are severely immunocompromised. "Mucormycosis" and "zygomycosis" often are used interchangeably; however, Zygomycota has been identified as polyphyletic and is not included in fungal classification systems. While zygomycosis includes Entomophthorales, mucormycosis excludes this group.
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PubMed References
| Healthcare Burden of Probable and Proven Invasive Mucormycosis: A Multicenter Cost-of-Illness Analysis of Patients Treated in Tertiary Care Hospitals between 2003 - 2016., Heimann SM,Vehreschild MJGT,Cornely OA,Heinz WJ,Grüner B,Silling G,Kessel J,Seidel D,Vehreschild JJ,, The Journal of hospital infection, 2018 Nov 10 [PubMed PMID: 30423409] | |
| Diagnosis and Treatment of Isolated Cerebral Mucormycosis: Patient-Level Data Meta-Analysis and Mayo Clinic Experience., Kerezoudis P,Watts CR,Bydon M,Dababneh AS,Deyo CN,Frye JM,Kelley PC,Kemp AM,Palraj BV,Pupillo GT,, World neurosurgery, 2018 Nov 8 [PubMed PMID: 30415043] | |
| Isolated renal mucormycosis in a patient with Idiopathic CD4 lymphocytopenia., Sethi J,Ramachandran R,Kohli HS,Gupta KL,, BMJ case reports, 2018 Nov 8 [PubMed PMID: 30413437] | |
| Surgery for Pulmonary Fungal Infections Complicating Hematological Malignancies., Yamamichi T,Horio H,Asakawa A,Okui M,Harada M,, The Korean journal of thoracic and cardiovascular surgery, 2018 Oct [PubMed PMID: 30402396] | |
| Treating mucormycosis using a multimodality approach: a case series., Gupta AK,Parwal C,Mangal M,Gambhir SS,Nanda BS,Sarangi K,, Journal of wound care, 2018 Nov 2 [PubMed PMID: 30398934] |
