17 May 2021 | Monday | News
Source : https://www.cdc.gov/
Healthcare providers who are concerned about an unusual number of new cases should contact their state or local public health agency.
Although most cases of mucormycosis are sporadic (not part of an outbreak), outbreaks of mucormycosis have occured. In healthcare settings, it can be difficult to determine whether mucormycosis is healthcare-associated or whether the infections were acquired somewhere else. Some examples of sources implicated in healthcare-associated mucormycosis outbreaks include adhesive bandages, wooden tongue depressors, hospital linens, negative pressure rooms, water leaks, poor air filtration, non-sterile medical devices, and building construction. 7-14 Community-onset outbreaks have been associated with trauma sustained during natural disasters. 15
Mucormycosis is rare, but the exact number of cases is difficult to determine because no national surveillance exists in the United States. Population-based incidence estimates for mucormycosis were obtained from laboratory surveillance in the San Francisco Bay Area during 1992–1993 and suggested a yearly rate of 1.7 cases per 1 million population. 1
Prospective surveillance among 16,808 transplant recipients performed in 23 institutions during 2001–2006 found that mucormycosis was the third most common type of invasive fungal infection in stem cell transplant recipients and accounted for 8% of all invasive fungal infections (77 mucormycete cases occurred among 983 stem cell transplant recipients who developed any fungal infection). 2,3 Among solid organ transplant recipients, mucormycosis accounted for 2% of all invasive fungal infections (28 mucormycete cases occurred among 1,208 solid organ transplant recipients who developed any fungal infection). 3,4 The number of cases varied widely across participating institutions.
Mucormycosis is frequently a life-threatening infection. A review of published mucormycosis cases found an overall all-cause mortality rate of 54%. 8 The mortality rate varied depending on underlying patient condition, type of fungus, and body site affected (for example, the mortality rate was 46% among people with sinus infections, 76% for pulmonary infections, and 96% for disseminated mucormycosis). 8
Symptoms of rhinocerebral (sinus and brain) mucormycosis include:
Symptoms of pulmonary (lung) mucormycosis include:
Cutaneous (skin) mucormycosis can look like blisters or ulcers, and the infected area may turn black. Other symptoms include pain, warmth, excessive redness, or swelling around a wound.
Symptoms of gastrointestinal mucormycosis include:
Disseminated mucormycosis typically occurs in people who are already sick from other medical conditions, so it can be difficult to know which symptoms are related to mucormycosis. Patients with disseminated infection in the brain can develop mental status changes or coma.
Mucormycosis is rare, but it’s more common among people who have health problems or take medicines that lower the body’s ability to fight germs and sickness. Certain groups of people are more likely to get mucormycosis, 1–3 including people with:
People get mucormycosis through contact with fungal spores in the environment. For example, the lung or sinus forms of the infection can occur after someone inhales the spores from the air. A skin infection can occur after the fungus enters the skin through a scrape, burn, or other type of skin injury.
No. Mucormycosis can’t spread between people or between people and animals.
It’s difficult to avoid breathing in fungal spores because the fungi that cause mucormycosis are common in the environment. There is no vaccine to prevent mucormycosis. For people who have weakened immune systems, there may be some ways to lower the chances of developing mucormycosis.
Healthcare providers consider your medical history, symptoms, physical examinations, and laboratory tests when diagnosing mucormycosis. Healthcare providers who suspect that you have mucormycosis in your lungs or sinuses might collect a sample of fluid from your respiratory system to send to a laboratory. Your healthcare provider may perform a tissue biopsy, in which a small sample of affected tissue is analyzed in a laboratory for evidence of mucormycosis under a microscope or in a fungal culture. You may also need imaging tests such as a CT scan of your lungs, sinuses, or other parts of your body, depending on the location of the suspected infection.
Mucormycosis is a serious infection and needs to be treated with prescription antifungal medicine, usually amphotericin B, posaconazole, or isavuconazole. These medicines are given through a vein (amphotericin B, posaconazole, isavuconazole) or by mouth (posaconazole, isavuconazole). Other medicines, including fluconazole, voriconazole, and echinocandins, do not work against fungi that cause mucormycosis. Often, mucormycosis requires surgery to cut away the infected tissue.