Mucormycosis - Revision history

Rossdonaldson1: /* Clinical Features */

2024-02-01T00:40:07Z

Clinical Features

← Revisión anterior		Revisión del 00:40 1 feb 2024
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	==Clinical Features==		==Clinical Features==
			[[File:PMC4439748 IDOJ-6-189-g001.png\|thumb\| A single well-defined black necrotic eschar measuring 5 cm × 3 cm over the right maxillary region in a patient with rhinocerebrocutaneous mucormycosis.]]
	[[File:PMC4503909 SaudiMedJ-36-865-g001.png\|thumb\|Palatal necrotic bone in a diabetic patient with rhino-orbital mucormycosis.]]		[[File:PMC4503909 SaudiMedJ-36-865-g001.png\|thumb\|Palatal necrotic bone in a diabetic patient with rhino-orbital mucormycosis.]]
	[[File:PMC4439748 IDOJ-6-189-g002.png\|thumb\|Single well-defined black necrotic eschar with slough on the hard palate in a patient with rhinocerebrocutaneous mucormycosis.]]		[[File:PMC4439748 IDOJ-6-189-g002.png\|thumb\|Single well-defined black necrotic eschar with slough on the hard palate in a patient with rhinocerebrocutaneous mucormycosis.]]

Rossdonaldson1: /* Clinical Features */

2022-12-14T22:48:30Z

Clinical Features

← Revisión anterior		Revisión del 22:48 14 dic 2022
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	==Clinical Features==		==Clinical Features==
	[[File:PMC4503909 SaudiMedJ-36-865-g001.png\|thumb\|Palatal necrotic bone in a diabetic ~~female~~ patient with rhino-orbital mucormycosis.]]		[[File:PMC4503909 SaudiMedJ-36-865-g001.png\|thumb\|Palatal necrotic bone in a diabetic patient with rhino-orbital mucormycosis.]]
			[[File:PMC4439748 IDOJ-6-189-g002.png\|thumb\|Single well-defined black necrotic eschar with slough on the hard palate in a patient with rhinocerebrocutaneous mucormycosis.]]
	[[File:Mucormycosis.png\|thumb\|Frontal abscess and periorbital edema in a patient with mucormycosis]]		[[File:Mucormycosis.png\|thumb\|Frontal abscess and periorbital edema in a patient with mucormycosis]]
	*Rhinocerebral form initially mimics acute bacterial [[sinusitis]] (pain/swelling of cheeks and periorbital region)<ref name="Motaleb" />		*Rhinocerebral form initially mimics acute bacterial [[sinusitis]] (pain/swelling of cheeks and periorbital region)<ref name="Motaleb" />

Rossdonaldson1: /* Clinical Features */

2022-12-14T22:25:52Z

Clinical Features

← Revisión anterior		Revisión del 22:25 14 dic 2022
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	==Clinical Features==		==Clinical Features==
			[[File:PMC4503909 SaudiMedJ-36-865-g001.png\|thumb\|Palatal necrotic bone in a diabetic female patient with rhino-orbital mucormycosis.]]
	[[File:Mucormycosis.png\|thumb\|Frontal abscess and periorbital edema in a patient with mucormycosis]]		[[File:Mucormycosis.png\|thumb\|Frontal abscess and periorbital edema in a patient with mucormycosis]]
	*Rhinocerebral form initially mimics acute bacterial [[sinusitis]] (pain/swelling of cheeks and periorbital region)<ref name="Motaleb" />		*Rhinocerebral form initially mimics acute bacterial [[sinusitis]] (pain/swelling of cheeks and periorbital region)<ref name="Motaleb" />

Kennybroccoli: /* Evaluation */

2022-12-13T07:55:51Z

Evaluation

← Revisión anterior		Revisión del 07:55 13 dic 2022
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	==Evaluation==		==Evaluation==
	*Can be clinical diagnosis - early diagnosis is critical to limiting spread of disease		*CT scan of sinuses with IV contrast can assist with diagnosis, often preferred over MRI as initial study as it is more readily available and more sensitive than MRI for bony erosions<ref>Aribandi M, McCoy VA, Bazan C 3rd. Imaging features of invasive and noninvasive fungal sinusitis: a review. Radiographics. 2007 Sep-Oct;27(5):1283-96. doi: 10.1148/rg.275065189. PMID: 17848691.</ref>
	*CT scan of sinuses with IV contrast can assist with diagnosis and ~~surgical planning~~		*PCR-based techniques on invasively-obtained histologic samples demonstrating fungal elements is confirmatory<ref>Walsh TJ, Gamaletsou MN, McGinnis MR, Hayden RT, Kontoyiannis DP. Early clinical and laboratory diagnosis of invasive pulmonary, extrapulmonary, and disseminated mucormycosis (zygomycosis). Clin Infect Dis. 2012 Feb;54 Suppl 1:S55-60. doi: 10.1093/cid/cir868. PMID: 22247446.</ref>
	*~~Histopathology~~ is confirmatory

	==Management==		==Management==

Elcatracho: /* Clinical Features */

2021-03-08T03:41:48Z

Clinical Features

← Revisión anterior		Revisión del 03:41 8 mar 2021
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	==Clinical Features==		==Clinical Features==
			[[File:Mucormycosis.png\|thumb\|Frontal abscess and periorbital edema in a patient with mucormycosis]]
	*Rhinocerebral form initially mimics acute bacterial [[sinusitis]] (pain/swelling of cheeks and periorbital region)<ref name="Motaleb" />		*Rhinocerebral form initially mimics acute bacterial [[sinusitis]] (pain/swelling of cheeks and periorbital region)<ref name="Motaleb" />
	**A much more rapid, extensive expansion of the fungus to the surrounding anatomy is classic		**A much more rapid, extensive expansion of the fungus to the surrounding anatomy is classic

Elcatracho: /* See Also */

2021-03-08T03:38:54Z

ClaireLewis at 21:17, 30 September 2019

2019-09-30T21:17:18Z

← Revisión anterior		Revisión del 21:17 30 sep 2019
Línea 1:		Línea 1:
	==Background==		==Background==
	*Opportunistic invasive fungal infection, typically affecting immunocompromised patients (~~esp~~ uncontrolled diabetics)<ref name="Selvamani">Selvamani M, Donoghue M, Bharani S, Madhushankari GS. Mucormycosis causing maxillary osteomyelitis. Journal of Natural Science, Biology, and Medicine. 2015;6(2):456-459. doi:10.4103/0976-9668.160039.</ref>		*Opportunistic invasive [[fungal infection]], typically affecting immunocompromised patients (especially uncontrolled diabetics)<ref name="Selvamani">Selvamani M, Donoghue M, Bharani S, Madhushankari GS. Mucormycosis causing maxillary osteomyelitis. Journal of Natural Science, Biology, and Medicine. 2015;6(2):456-459. doi:10.4103/0976-9668.160039.</ref>
	*Caused by saprophytic fungi (''Mucorales'')		*Caused by saprophytic fungi (''Mucorales'')
	**Found in soil, bread mold, decaying fruits<ref name="Motaleb">Motaleb HYA, Mohamed MS, Mobarak FA. A Fatal Outcome of Rhino-orbito-cerebral Mucormycosis Following Tooth Extraction: A Case Report. Journal of International Oral Health : JIOH. 2015;7(Suppl 1):68-71.</ref>		**Found in soil, bread mold, decaying fruits<ref name="Motaleb">Motaleb HYA, Mohamed MS, Mobarak FA. A Fatal Outcome of Rhino-orbito-cerebral Mucormycosis Following Tooth Extraction: A Case Report. Journal of International Oral Health : JIOH. 2015;7(Suppl 1):68-71.</ref>
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	==Clinical Features==		==Clinical Features==
	*Rhinocerebral form initially mimics acute bacterial sinusitis (pain/swelling of cheeks and periorbital region)<ref name="Motaleb" />		*Rhinocerebral form initially mimics acute bacterial [[sinusitis]] (pain/swelling of cheeks and periorbital region)<ref name="Motaleb" />
	**A much more rapid, extensive expansion of the fungus to the surrounding anatomy is classic		**A much more rapid, extensive expansion of the fungus to the surrounding anatomy is classic
	**Can spread to orbits, oropharynx, nasopharynx, brain, nearby vasculature leading to → ~~Vision~~ changes, nasopharyngeal and oropharyngeal ulceration or eschars, facial edema/pain, cranial nerve deficits, headache		**Can spread to orbits, oropharynx, nasopharynx, brain, nearby vasculature leading to → [[vision loss\|vision changes]], nasopharyngeal and oropharyngeal ulceration or eschars, facial edema/pain, [[cranial nerve palsies\|cranial nerve deficits]], [[headache]]
	**Black palatal discoloration indicates palatal necrosis		**Black palatal discoloration indicates palatal necrosis

	==Differential Diagnosis==		==Differential Diagnosis==
			{{Rhinorrhea}}
			{{Headache DDX}}

	==Evaluation==		==Evaluation==

Neil.m.young: Text replacement - "==Diagnostic Evaluation==" to "==Evaluation=="

2016-07-28T04:41:18Z

Text replacement - "==Diagnostic Evaluation==" to "==Evaluation=="

← Revisión anterior		Revisión del 04:41 28 jul 2016
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	==~~Diagnostic~~ Evaluation==		==Evaluation==
	*Can be clinical diagnosis - early diagnosis is critical to limiting spread of disease		*Can be clinical diagnosis - early diagnosis is critical to limiting spread of disease
	*CT scan of sinuses with IV contrast can assist with diagnosis and surgical planning		*CT scan of sinuses with IV contrast can assist with diagnosis and surgical planning

Neil.m.young: Text replacement - "1 mg" to "1mg"

2016-07-21T08:15:48Z

Text replacement - "1 mg" to "1mg"

← Revisión anterior		Revisión del 08:15 21 jul 2016
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	==Management==		==Management==
	*Emergent ENT consult for OR debridement (definitive treatment)		*Emergent ENT consult for OR debridement (definitive treatment)
	*Start [[Amphotericin B]] ~~1 mg~~/kg IV<ref name="Motaleb" /> '''OR'''		*Start [[Amphotericin B]] 1mg/kg IV<ref name="Motaleb" /> '''OR'''
	**Liposomal [[Amphotericin B]] 5-10mg/kg<ref name="Bellazreg">Bellazreg F, Hattab Z, Meksi S, et al. Outcome of mucormycosis after treatment: report of five cases. New Microbes and New Infections. 2015;6:49-52. doi:10.1016/j.nmni.2014.12.002.</ref>		**Liposomal [[Amphotericin B]] 5-10mg/kg<ref name="Bellazreg">Bellazreg F, Hattab Z, Meksi S, et al. Outcome of mucormycosis after treatment: report of five cases. New Microbes and New Infections. 2015;6:49-52. doi:10.1016/j.nmni.2014.12.002.</ref>
	*Aggressive resuscitation, airway management, and supportive care while in ED.		*Aggressive resuscitation, airway management, and supportive care while in ED.

Neil.m.young: Text replacement - "0 mg" to "0mg"

2016-07-19T18:05:42Z

Text replacement - "0 mg" to "0mg"

← Revisión anterior		Revisión del 18:05 19 jul 2016
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	*Emergent ENT consult for OR debridement (definitive treatment)		*Emergent ENT consult for OR debridement (definitive treatment)
	*Start [[Amphotericin B]] 1 mg/kg IV<ref name="Motaleb" /> '''OR'''		*Start [[Amphotericin B]] 1 mg/kg IV<ref name="Motaleb" /> '''OR'''
	**Liposomal [[Amphotericin B]] 5-~~10 mg~~/kg<ref name="Bellazreg">Bellazreg F, Hattab Z, Meksi S, et al. Outcome of mucormycosis after treatment: report of five cases. New Microbes and New Infections. 2015;6:49-52. doi:10.1016/j.nmni.2014.12.002.</ref>		**Liposomal [[Amphotericin B]] 5-10mg/kg<ref name="Bellazreg">Bellazreg F, Hattab Z, Meksi S, et al. Outcome of mucormycosis after treatment: report of five cases. New Microbes and New Infections. 2015;6:49-52. doi:10.1016/j.nmni.2014.12.002.</ref>
	*Aggressive resuscitation, airway management, and supportive care while in ED.		*Aggressive resuscitation, airway management, and supportive care while in ED.
	*Hyperbaric oxygen therapy<ref name="Mohamed" /> and iron chelation (iron is required for fungal growth) may also help.<ref name="Motaleb" />		*Hyperbaric oxygen therapy<ref name="Mohamed" /> and iron chelation (iron is required for fungal growth) may also help.<ref name="Motaleb" />

← Revisión anterior		Revisión del 03:38 8 mar 2021
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	==See Also==		==See Also==
	*[[Fungal Infections]]		*[[Fungal Infections]]
			*[[Antifungals]]

	==External Links==		==External Links==