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Zygomycosis Treatment & Management

  • Author: Jose A Vazquez, MD, FACP, FIDSA; Chief Editor: Mark R Wallace, MD, FACP, FIDSA  more...
 
Updated: Aug 12, 2015
 

Medical Care

Take aggressive surgical measures to débride affected tissue. Without early and aggressive therapy, mucormycosis is almost always fatal.

Take aggressive measures to control the underlying condition, as follows:

  • Correct hyperglycemia and ketoacidosis to improve outcome.
  • Correct neutropenia with granulocyte colony-stimulating factor (G-CSF) or granulocyte-macrophage colony-stimulating factor (GM-CSF) to improve outcome.

Institute early and appropriate antifungal administration.

If possible, discontinue any immunosuppressant agents, including chemotherapy and steroids.

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Surgical Care

The mainstay of treatment for any form of mucormycosis is early and aggressive surgical removal of all infected tissue.

Remove as much devitalized tissue as possible and consider wide surgical debridement, if feasible.

Patients with mucormycosis frequently require numerous surgical procedures to eradicate all infected and necrotic material.

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Consultations

See the list below:

  • Infectious disease specialist
  • Surgeon
  • Otorhinolaryngologist
  • Gastroenterologist
  • Pulmonologist
  • Ophthalmologist
  • Neurosurgeon
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Contributor Information and Disclosures
Author

Jose A Vazquez, MD, FACP, FIDSA Professor of Medicine, Section Chief, Division of Infectious Diseases, Department of Medicine, Georgia Regents University

Jose A Vazquez, MD, FACP, FIDSA is a member of the following medical societies: American College of Physicians, American Society for Microbiology, Infectious Diseases Society of America, International AIDS Society, International Immunocompromised Host Society, International Society for Infectious Diseases, Medical Mycological Society of the Americas, International Society for Human and Animal Mycology, HIV Medicine Association, Michigan Infectious Disease Society, National Foundation for Infectious Diseases, Mycological Society of America, Immunocompromised Host Society

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Allergan; Astellas; Pfizer<br/>Received research grant from: Merck; Astellas<br/>Received grant/research funds from Merck for independent contractor; Received honoraria from Forest for speaking and teaching; Received honoraria from Astellas for speaking and teaching; Received consulting fee from Cidara for consulting.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

John L Brusch, MD, FACP Assistant Professor of Medicine, Harvard Medical School; Consulting Staff, Department of Medicine and Infectious Disease Service, Cambridge Health Alliance

John L Brusch, MD, FACP is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Mark R Wallace, MD, FACP, FIDSA Clinical Professor of Medicine, Florida State University College of Medicine; Clinical Professor of Medicine, University of Central Florida College of Medicine

Mark R Wallace, MD, FACP, FIDSA is a member of the following medical societies: American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, International AIDS Society, Florida Infectious Diseases Society

Disclosure: Nothing to disclose.

Additional Contributors

Gary L Gorby, MD Associate Professor, Departments of Internal Medicine and Medical Microbiology and Immunology, Division of Infectious Diseases, Creighton University School of Medicine; Associate Professor of Medicine, University of Nebraska Medical Center; Associate Chair, Omaha Veterans Affairs Medical Center

Gary L Gorby, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, New York Academy of Sciences

Disclosure: Nothing to disclose.

References
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A 45-year-old woman with poorly controlled diabetes mellitus with facial and periorbital swelling due to zygomycosis. She was unable to open her right eye upon admission.
Material from the periorbital tissue of a woman with poorly controlled diabetes mellitus with facial and periorbital swelling due to zygomycosis is stained with periodic acid-Schiff stain (X 560). The material demonstrates the classic appearance of irregularly shaped broad hyphae with right-angle branching (arrow).
A CT scan of the head of a patient with zygomycosis shows involvement of the paranasal sinuses and periorbital soft tissues.
A 60-year-old woman with diabetes mellitus and 5 days post operative from resection of a benign pituitary tumor. The lesion developed over the surgical scar. Biopsy of lesion demonstrated invasive cutaneous mucormycosis.
 
 
 
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