Zygomycosis

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Obesity, Sleep & Internal medicine
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Zygomycosis
Synonyms	Mucormycosis, Phycomycosis
Pronounce	N/A
Specialty	N/A
Symptoms	Fever, headache, facial swelling, nasal congestion, black lesions on nasal bridge or upper inside of mouth
Complications	Tissue necrosis, blindness, cerebral infarction, death
Onset	Rapid
Duration	Variable
Types	N/A
Causes	Fungal infection by Mucorales
Risks	Diabetes mellitus, immunosuppression, iron overload, trauma, burns
Diagnosis	Biopsy, culture, imaging studies
Differential diagnosis	Bacterial sinusitis, aspergillosis, granulomatosis with polyangiitis
Prevention	N/A
Treatment	Antifungal medication, surgical debridement
Medication	Amphotericin B, posaconazole, isavuconazole
Prognosis	Poor if untreated
Frequency	Rare
Deaths	N/A

Zygomycosis, also known as mucormycosis, is a serious fungal infection caused by fungi in the order Mucorales. This rare but potentially life-threatening condition primarily affects individuals with compromised immune systems, such as those with uncontrolled diabetes, cancer patients, organ transplant recipients, and individuals receiving immunosuppressive drugs.

Causes and Risk Factors

Zygomycosis is caused by the inhalation of fungal spores from the environment. The fungi responsible for this infection belong to several genera, most notably Rhizopus, Mucor, and Absidia. These fungi are ubiquitous in nature, found in soil, decaying organic matter, and even in the air. While these spores are commonly inhaled by people every day without causing infection, individuals with weakened immune systems are at a higher risk of developing zygomycosis.

Symptoms and Diagnosis

The symptoms of zygomycosis vary depending on the part of the body affected. The infection can manifest in several forms, including rhinocerebral, pulmonary, cutaneous, gastrointestinal, and disseminated zygomycosis. The most common form, rhinocerebral zygomycosis, begins with symptoms such as fever, nasal congestion, and headaches. As the infection progresses, it can lead to facial swelling, black lesions on the nasal bridge or upper inside of the mouth, and potentially, loss of vision or neurological deficits. Diagnosis of zygomycosis involves a combination of clinical assessment, imaging studies, and laboratory tests. Biopsy and culture of the affected tissues are crucial for confirming the presence of the fungi.

Treatment

Treatment of zygomycosis requires an aggressive approach that includes antifungal therapy, surgical debridement of infected tissue, and management of underlying conditions. The primary antifungal medication used is Amphotericin B, although newer agents like posaconazole and isavuconazole have also been used. Early diagnosis and treatment are critical for improving outcomes, as the infection can rapidly become fatal if not promptly addressed.

Prevention

Preventive measures for zygomycosis are primarily focused on individuals with high-risk conditions. These include controlling diabetes mellitus, reducing the use of immunosuppressive drugs when possible, and employing protective measures in environments with a high concentration of fungal spores.

Epidemiology

Zygomycosis is a rare infection, with its incidence increasing in recent years, possibly due to the growing number of individuals with compromised immune systems. It has a global distribution, with no specific geographic predilection.

Prognosis

The prognosis for individuals with zygomycosis depends on several factors, including the site of infection, the extent of disease, the patient's immune status, and the timeliness of treatment. Despite aggressive treatment, the mortality rate remains high, especially in cases of disseminated infection.

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