Video:Zygomycosis

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Description

Zygomycosis, is a rare but serious fungal infection caused by a group of molds called mucormycetes.Zygomycosis is characterized by tissue infarction and necrosis.It can be transmitted by inhaling spores or by direct inoculation on disrupted skin or mucosa. Treatment is done via aggressive surgical and medical therapy.[1][2]

Presentation

As to the presentation of Zygomycosis we find the following, headaches,lethargy, nausea, fever, and nasal congestion.[2]

Complications

The complications consistent with an individual affected by Zygomycosis are the following: meningitis, Garcin syndrome, brain abscess, Orbital apex syndrome and facial deformity.[1][2]

Cause

Pathogenic zygomycosis is caused by species in two orders, Mucorales and Entomophthorales, with the former causing far more disease than the latter.[3]

Mechanism

In terms of the mechanism we find that infection starts in nasal cavity and multiplies. As to the degree of infiltration is due to duration of infection, the persons immune response, and disease severity. Fungal hyphae that invade blood vessels cause damage to the endothelium, resulting in blood clots that eventually cause ischemia and necrosis. This affected tissue is a breeding ground for the infection, allowing it via the bloodstream into other parts of the body.[2]

Diagnosis

We find that the evaluation of Zygomycosis is based on clinical findings , biopsy and CT scan.[2]

Differential diagnosis

The differential diagnosis of Zygomycosis in the affected individual is as follows: Aspergillosis, bacterial sinusitis, Cavernous sinus thrombosis and Paranasal malignancies.[2]

Treatment

Due to the organisms' rapid growth and invasion, zygomycosis could present with a high fatality rate. Treatment must begin immediately with debridement of the necrotic tissue plus Amphotericin B.[4] Complete excision of the infectious tissue may be required as suspected dead tissue must be excised aggressively.[5][6][7]

Prognosis

In terms of the prognosis of zygomycosis we find it can be poor, particularly in immunocompromised individuals, such as in uncontrolled diabetes, cancer, or organ transplantation.[8]

Epidemiology

Zygomycosis has been found in survivors of the 2004 Indian Ocean earthquake and tsunami and in survivors of the 2011 Joplin, Missouri tornado.[9]

History

In terms of history we find that the first case of zygomycosis in humans was reported in 1885 by Platauf, who at the time described it as "Mycosis Mucorina".[10]

References

  1. 1.0 1.1 "Zygomycosis". DermNet®. 26 October 2023. Archived from the original on 23 April 2021. Retrieved 29 November 2024.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 Bhandari, Jenish; Thada, Pawan K.; Nagalli, Shivaraj (2024). "Rhinocerebral Mucormycosis". StatPearls. StatPearls Publishing.
  3. Ribes, J. A.; Vanover-Sams, C. L.; Baker, D. J. (2000). "Zygomycetes in Human Disease". Clinical Microbiology Reviews. 13 (2): 236–301. doi:10.1128/CMR.13.2.236. PMC 100153. PMID 10756000.
  4. Moscatello, Kim (2013). USMLE Step 1: Immunology and Microbiology Lecture Notes. Chicago: Kaplan Publishing. pp. 430–431. ISBN 978-1625232557.
  5. Spellberg, Brad; Walsh, Thomas J.; Kontoyiannis, Dimitrios P.; Edwards, Jr.; Ibrahim, Ashraf S. (2009). "Recent Advances in the Management of Mucormycosis: From Bench to Bedside". Clinical Infectious Diseases. 48 (12): 1743–51. doi:10.1086/599105. PMC 2809216. PMID 19435437.
  6. Grooters, A (2003). "Pythiosis, lagenidiosis, and zygomycosis in small animals". Veterinary Clinics of North America: Small Animal Practice. 33 (4): 695–720. doi:10.1016/S0195-5616(03)00034-2. PMID 12910739.
  7. Li, HouMin; Hwang, Sonia Kay; Zhou, Cheng; Du, Juan; Zhang, JianZhong (2013). "Gangrenous Cutaneous Mucormycosis Caused by Rhizopus oryzae: A Case Report and Review of Primary Cutaneous Mucormycosis in China Over Past 20 Years". Mycopathologia. 176 (1–2): 123–128. doi:10.1007/s11046-013-9654-z. ISSN 0301-486X.
  8. "Clinical Overview of Mucormycosis". Mucormycosis. 26 April 2024. Retrieved 6 December 2024.
  9. "Joplin toll rises to 151; some suffer from fungus". Associated Press. 10 June 2011. Archived from the original on 10 December 2019. Retrieved 17 February 2021 – via Medical Xpress.
  10. Antachopoulos, Charalampos; Petraitiene, Ruta; Roilides, Emmanuel; Walsh, Thomas J. (2015). "Mucormycosis (Zygomycosis)". Diagnosis and Treatment of Fungal Infections. Springer International Publishing: 159–168. doi:10.1007/978-3-319-13090-3_13. ISBN 978-3-319-13089-7.