Mucormycosis—A clinicoepidemiological review of cases over 10 years. Issue 4 (19th February 2019)

• Record Type: Journal Article
• Authors: Manesh, Abi; Rupali, Priscilla; Sullivan, Maire O.; Mohanraj, Promila; Rupa, Vedantam; George, Biju; Michael, Joy S.
• Is Part Of: Mycoses. Volume 62:Issue 4(2019)
• Page Start: 391
• Page End: 398
• Publication Date: 2019-02-19
• Subjects: epidemiology -- haematological conditions -- mucormycosis -- outcomes -- ROCM; Pathogenic fungi -- Periodicals; Medical mycology -- Periodicals; 616.969
• DOI: 10.1111/myc.12897
• Languages: English
• ISSNs: 0933-7407

Abstract

Summary: Background: Limited data exist for epidemiology and outcomes of various agents causing mucormycosis in various clinical settings from developing countries like India. Objectives: To study the epidemiology and outcomes of various agents causing mucormycosis in different clinical settings in a tertiary care hospital from South India. Patients and methods: We reviewed details of 184 consecutive patients with culture‐proven mucormycosis with consistent clinical syndrome and supporting features from September 2005 to September 2015. Results: The mean age of patients was 50.42 years; 70.97% were male. Unlike developed countries, R microsporus (29/184; 15.7%) and Apophysomyces elegans (20/184; 10.8%) also evolved as important pathogens in addition to R arrhizus in our setting. Paranasal sinuses (136/184; 73.9%) followed by musculoskeletal system (28/184; 15.2%) were the common areas of involvement. Apophysomyces elegans typically produced skin and musculoskeletal disease in immune‐competent individuals with trauma (12/20; 60%) and caused significantly lower mortality ( P = 0.03). R microsporus was more common in patients with haematological conditions (25% vs 15.7%) and was less frequently a cause for sinusitis than R arrhizus (27.58% vs 10.9%). The overall mortality was 30.97%. Combination therapy with surgery and antifungals offered the best chance for cure. Conclusions: Agents causing mucormycosis may have unique clinical and epidemiological characteristics.