For further information, see CMDT Part 36-08: Mucormycosis
Most common cause of non-Aspergillus invasive mold infection
Lungs, rhinocerebral, and skin are most common disease sites
Rapidly fatal without multidisciplinary interventions
The term "mucormycosis" applies to opportunistic infections caused by members of the genera Rhizopus, Mucor, Lichtheimia (formerly Absidia), and Cunninghamella
Predisposing conditions include
Stem cell transplantation
Solid organ transplantation
Chronic kidney disease
Use of corticosteroids or cytotoxic drugs
Invasive disease of the sinuses, orbits, and the lungs may occur
Necrosis is common due to hyphal tissue invasion that may manifest as ulceration of the hard palate or nasal palate or hemoptysis
Widely disseminated disease can occur
No serologic or laboratory findings assist with diagnosis
Blood cultures are unhelpful
A reverse halo sign may be seen on chest CT
Cultures frequently negative
Biopsy almost always required for diagnosis. Histology demonstrates organisms in tissues as broad, branching nonseptate hyphae
Optimal therapy involves
A prolonged course of a lipid preparation of intravenous liposomal amphotericin B (5 mg/kg with higher doses possibly given for CNS disease) should be started early
Oral posaconazole (300 mg/day) or oral isavuconazole (200 mg every 8 hours for 1–2 days, then 200 mg daily thereafter) can be used for
Combination therapy with amphotericin and posaconazole or isavuconazole is not proven but is commonly used because of the poor response to monotherapy
et al. Mucormycosis treatment: recommendations, latest advances, and perspectives. J Mycol Med. 2020;30:101007.
et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis. 2019;19:e405.
et al. Evaluation of mass spectrometry-based detection of panfungal serum disaccharide for diagnosis of invasive fungal infections: results from a collaborative study involving six European clinical centers. J Clin Microbiol. 2019;57:e01867.
et al. Breakthrough invasive mold infections in the hematology patient: current concepts and future directions. Clin Infect Dis. 2018;67:1621.