Disease Entities in Mucormycosis

被引:95
作者
Serris, Alexandra [1 ]
Danion, Francois [1 ]
Lanternier, Fanny [1 ,2 ]
机构
[1] Univ Paris 05, IHU Imagine, Ctr Infectiol Necker Pasteur, Hop Necker Enfants Malad,AP HP, F-75015 Paris, France
[2] Inst Pasteur, Ctr Natl Reference Mycoses Invas & Antifong, Unite Mycol Mol, F-75015 Paris, France
关键词
Mucormycosis; Mucorales; rhino-orbito-cerebral mucormycosis; pulmonary mucormycosis; health-care; REVERSED HALO SIGN; PULMONARY MUCORMYCOSIS; TRANSPLANT RECIPIENTS; MOLD INFECTIONS; EARLY-DIAGNOSIS; ZYGOMYCOSIS; EPIDEMIOLOGY; OUTBREAK; FRANCE;
D O I
10.3390/jof5010023
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
Mucormycosis is an emerging life-threatening fungal infection caused by Mucorales. This infection occurs mainly in immunocompromised patients, especially with hematological malignancy, transplantation, or diabetes mellitus. Rhino-orbito-cerebral and pulmonary mucormycosis are the predominant forms. Interestingly, location is associated with the underlying disease as pulmonary mucormycosis is more frequent in hematological malignancy patients whereas rhino-orbito-cerebral mucormycosis is associated with diabetes. Cutaneous mucormycosis results from direct inoculation, mainly after trauma or surgery. Gastro-intestinal mucormycosis occurs after ingestion of contaminated food or with contaminated device and involves the stomach or colon. Disseminated disease is the most severe form and is associated with profound immunosuppression. Uncommon presentations with endocarditis, osteoarticluar or isolated cerebral infections are also described. Finally, health-care associated mucormycosis is a matter of concern in premature newborns and burn units. Clinical symptoms and CT scan findings are not specific, only the early reversed halo sign is associated with pulmonary mucormycosis. Circulating Mucorales DNA detection is a recent promising diagnostic tool that may lead to improving the diagnosis and prompting therapeutic initiation that should include antifungal treatment, correction of the underlying disease and surgery when feasible.
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页数:9
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