Mucormycosis in Iran: a systematic review. Issue 7 (15th February 2016)

• Record Type: Journal Article
• Authors: Vaezi, Afsane; Moazeni, Maryam; Rahimi, Mohammad Taghi; de Hoog, Sybren; Badali, Hamid
• Is Part Of: Mycoses. Volume 59:Issue 7(2016)
• Page Start: 402
• Page End: 415
• Publication Date: 2016-02-15
• Subjects: Mucormycosis -- Mucor -- Rhizomucor -- diabetes -- systematic review -- Iran; Pathogenic fungi -- Periodicals; Medical mycology -- Periodicals; 616.969
• DOI: 10.1111/myc.12474
• Languages: English
• ISSNs: 0933-7407

Abstract

Summary: Fungi in the order Mucorales cause acute, invasive and frequently fatal infections in susceptible patients. This study aimed to perform a systematic review of all reported mucormycosis cases during the last 25 years in Iran. After a comprehensive literature search, we identified 98 cases in Iran from 1990–2015. The mean patient age was 39.8 ± 19.2 years. Diabetes was the most common underlying condition (47.9%), and 22.4% of the patients underwent solid organ or bone marrow transplantation. The most common clinical forms of mucormycosis were rhinocerebral (48.9%), pulmonary (9.2%) and cutaneous (9.2%). Eight cases of disseminated disease were identified. Overall mortality in the identified cases was 40.8%, with the highest mortality rate in patients diagnosed with disseminated infection (75%). The mortality rate in rhinocerebral infection patients was significantly lower (45.8%). Rhinocerebral infection was the most common clinical manifestation in diabetes patients (72.9%). Patients were diagnosed using various methods including histopathology (85.7%), microscopy (12.3%) and culture (2.0%). Rhizopus species were the most prevalent (51.7%), followed by Mucor species (17.2%). Sixty‐nine patients were treated with a combination of surgery and antifungal therapy (resulting survival rate, 66.7%). Owing to the high mortality rate of advanced mucormycosis, early diagnosis and treatment may significantly improve survival rates. Therefore, increased monitoring and awareness of this life‐threatening disease is critical.