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Infection-Associated Ocular Cranial Nerve Palsies
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Hardeep Singh Malhotra, Imran Rizvi, Neeraj Kumar, Kiran Preet Malhotra, Gaurav Kumar, Manoj K. Goyal, Manish Modi, Ravindra Kumar Garg, Vivek Lal
Mucormycosis is a relatively rare (usually not more than 10% of Aspergillosis) but fatal fungal infection with high potential of causing mortality and significant morbidity. Four genera of mucorales are associated with human disease (Rhizopus, Mucor, Absidia, and Cunninghamella). Rhino-orbito-cerebral form is one of the common manifestations of mucormycosis. Other clinical syndromes are pulmonary, gastrointestinal, cutaneous, and disseminated forms. Initial human infection is either secondary to inhalation of sporangiospores or inoculation of wound. Immunocompromised individuals are at highest risk of contracting the infection. Uncontrolled diabetes mellitus, deferoxamine therapy, anti-neoplastic administration, malignancy, burns, and trauma pose a higher risk of developing mucormycosis.
Mucormycosis
Published in Srijan Goswami, Chiranjeeb Dey, COVID-19 and SARS-CoV-2, 2022
Soumyajit Dutta, Srijan Goswami
Mucormycosis is an angioinvasive, non-contagious but serious life-threatening disease known to be caused by a group of fungi called mucormycetes. The word “mucormycosis” is derived from two Latin words Mucor and mycosis. The word Mucor (Latin) refers to mold and mycosis (Latin) refers to “the presence of fungi as parasites in the body”. The mucormycetes group of fungi can be found everywhere in the environment especially on surfaces with dead and decaying organic matter. Encounters with these fungi groups are completely unavoidable but they are not harmful to the majority of the human population. However, in individuals with immunosuppressive conditions, inhalation of the spores from the fungi may cause pulmonary infection and inflammation of nasal sinuses or may even spread to different locations of the body, thus causing a serious pathological state (WHO, 2021; CDC, 2021). Mucormycosis may be caused by several types of fungi belonging to the order Mucorales. According to the Centers for Disease Control and Prevention (CDC), Rhizopus and Mucor are the two most common species of fungus that are known to cause mucormycosis, the other possible names include Rhizomucor species, Cunninghamella bertholletiae, Apophysomyces, Lichtheimia, and Saksenaea (WHO, 2021; CDC, 2021).
Pulmonary Mucormycosis with a Staphylococcus epidermidis Co-infection
Published in Wickii T. Vigneswaran, Thoracic Surgery, 2019
Albert Pai, Kalpaj R. Parekh, Evgeny V. Arshava
Mucormycosis is commonly associated with an immunosuppressed state, active malignancy, uncontrolled diabetes, and iron-overloaded states [1]. In patients with hematological malignancies, mucormycosis most commonly affects the lungs. Due to the angioinvasive nature of Mucor, there is an overall mortality of 70%–80% associated with delayed diagnosis and treatment of pulmonary infection [2,3].
The rise of mucormycosis in Covid-19 patients in India
Published in Expert Review of Anti-infective Therapy, 2022
The health-care system in India has been unable to cope with the onslaught of wave 2 Covid-19 pandemic. At its peak in early May 2021, over 400,000 cases of Covid-19 were being reported on a daily basis [1], and India found itself unprepared with acute shortage of drugs, vaccines, ventilators, and oxygen [2]. Although Covid cases are currently getting under control, India is now facing a public health emergency of mucormycosis, commonly labeled as ‘black fungus,’ a rare but potentially fatal fungal infection. Mucormycosis is caused by the mucormycetes, a group of molds, with Rhizopus and Mucor as the most common species [3]. As announced by Mr Harsh Vardhan, the former Health Minister of India, there are over 40,000 cases of mucormycosis reported as of 28 June 2021 [4]. Mucormycosis has been declared an epidemic in several Indian states and has been classified as a notifiable disease. Early diagnosis and prompt initiation of treatment is crucial as the condition can progress rapidly with fatal outcome. The treatment for this condition is based on a combination of antifungal medication and aggressive surgical debridement of necrotic tissue if necessary. The recommended anti-fungal drug is Liposomal Amphotericin B on a dose of 5 mg/kg/day. However, acute shortage of Amphotericin B on the one hand and its prohibitive cost to patients and their families on the other is a major challenge.
Mucormycosis medications: a patent review
Published in Expert Opinion on Therapeutic Patents, 2021
Mohd. Imran, Alshrari A.S., Mohammad Tauseef, Shah Alam Khan, Shuaibu Abdullahi Hudu
Mucormycosis (phycomycosis or zygomycosis) is a noninfectious fungal disease caused by different genera of zygomycetes. The mucormycosis term is widely used because members of the Mucoraceae family cause most of these infections [1]. The Mucoraceae family members are present worldwide and are known to start the decay of organic materials [2]. Rhizopus arrhizus is the most common cause of mucormycosis in humans. Other fungi reported causing mucormycosis to include Mucor sp., Saksenaea sp., Absidia sp., Entomophthora sp., Basidiobolus sp., Conidiobolus sp., Apophysomyces elegans, Cunninghamella bertholletiae, and Rhizomucor pusillus [1,3]. This uncommon infection occurs when a healthy individual’s mouth, nose, eyes, cracked skin and wound come in direct contact with contaminated soil or water. After the illness, the fungi rapidly multiply at the blood vessel walls and stop the tissue/organ’s blood supply. This results in tissue destruction, and if not treated on time, leads to infection of the different parts of the body, followed by death [1–4]. This illness is also termed as ‘Black Death’ and ‘Zombie disease’ in layman’s language. However, these terms are not be used by a responsible individual to avoid misunderstanding between the patient and the public [5].
A case of mistaken identity: Saksenaea vasiformis of the orbit
Published in Orbit, 2021
Allison J. Chen, Lilangi S. Ediriwickrema, Rohan Verma, Vera Vavinskaya, Solomon Shaftel, Adam S. Deconde, Bobby S. Korn, Don O. Kikkawa, Catherine Y. Liu
This is a rare case of chronic, invasive rhino-orbital Saksenaea vasiformis infection. To the authors' knowledge, there are two prior cases reported in a 21-month-old child in sub-Saharan Africa and in an 11-year-old child in Missouri, both of whom were immunocompetent, presented in a subacute fashion, and received systemic, but not intra-orbital, antifungal treatment.5,6 On pathology, it is difficult and sometimes not possible to distinguish this diagnosis from Mucor as both produce broad irregularly branching hyphae with rare or no septations. Furthermore, growth on media requires extended time and use of nutrient-depleted media such as tap water agar to induce sporulation.7Saksenaea typically infects skin and soft tissue in immunocompetent hosts and is generally susceptible to systemic AmB and posaconazole treatment.8 The patient presented to our hospital with the presumed diagnosis of Mucor. Given the high associated mortality rate, the patient was initially treated accordingly. Her stable appearance and immunocompetence, however, raised suspicion for an alternate diagnosis.