Mucormycosis (previously called zygomycosis) is a serious but rare fungal infection caused by a group of molds called mucormycetes. These molds live throughout the environment. Mucormycosis mainly affects people who have health problems or take medicines that lower the body’s ability to fight germs and sickness. It most commonly affects the sinuses or the lungs after inhaling fungal spores from the air. It can also occur on the skin after a cut, burn, or other types of skin injury.
Rhinocerebral (sinus and brain) mucormycosis is an infection in the sinuses that can spread to the brain. This form of mucormycosis is most common in people with uncontrolled diabetes and in people who have had a kidney transplant.
Symptoms of rhinocerebral (sinus and brain) mucormycosis include:
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.
The fungi that cause mucormycosis live in the environment.
Several different types of fungi can cause mucormycosis. These fungi are called mucormycetes and belong to the scientific order Mucorales. The most common types that cause mucormycosis are Rhizopus species and Mucor species.
There are five major clinical forms of mucormycosis; of these, rhinocerebral and pulmonary infections are the most common. A classic clinical sign of mucormycosis is the rapid onset of tissue necrosis with or without fever. Necrosis is the result of invasion of blood vessels and subsequent thrombosis.
Rhinocerebral mucormycosis is the most common form in patients with diabetes and with renal transplants. It also occurs in neutropenic cancer patients and hematopoietic stem cell transplant or solid organ transplant recipients. Symptoms may include unilateral facial swelling, headaches, nasal or sinus congestion or pain, serosanguinous nasal discharge, and fever. As the infection spreads, ptosis, proptosis, loss of extraocular muscle function, and vision disturbance may occur. Necrotic black lesions on the hard palate or nasal turbinate and drainage of black pus from the eyes are useful diagnostic signs.
Risk groups for mucormycosis include persons with uncontrolled diabetes; malignancy; hematopoietic stem cell transplant or solid organ transplant; persistent neutropenia; prolonged corticosteroid therapy; skin trauma, burns, or surgical wounds; iron overload; intravenous drug use; malnourishment; and premature infants.
Although most cases of mucormycosis are sporadic (not part of an outbreak), outbreaks of mucormycosis have occurred. 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. Community-onset outbreaks have been associated with trauma sustained during natural disasters.
Mucormycosis is frequently a life-threatening infection. A review of published mucormycosis cases found an overall all-cause mortality rate of 54%. The mortality rate varied depending on the 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).