Clinical characteristics and outcome of mucormycosis: A multi-center retrospective analysis in Saudi Arabia over 11 years

Background: Mucormycosis is a life-threatening fungal infection with variable epidemiology between countries. Limited data are available locally; we aim to describe the clinical spectrum and outcome of mucormycosis in Saudi Arabia. Methods: A retrospective multi-center study including all patients with clinical and pathological evidence of mucormycosis in 3 tertiary care centers in Saudi Arabia from January 2009 to December 2019. Results: Thirty-three patients were identified during the study period. The mean age was 42 years. People with diabetes accounted for 48% of the patient population. The most common site of infection was cutaneous (27%), followed by isolated sinusitis (21%) and pulmonary and rhino-orbital-cerebral mucormycosis (each 18%). The most common isolated species were Rhizopus (50%) and Mucor (15%). Most patients received medical therapy with amphotericin B (79%), and more than half were treated surgically. The 1-year mortality rate reached 48%, with higher mortality observed in disseminated and rhino-orbital-cerebral infections than in other sites.Conclusion: Our study addressed the epidemiology of mucormycosis in Saudi Arabia and showed comparable patterns of clinical and mycological aspects to worldwide reports. Further studies are needed to evaluate mucormycosis risk factors and prognosis based on the species, site of infection and therapy type.