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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.


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.



See the list below:

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

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.

  1. Kwon-Chung KJ. Taxonomy of fungi causing mucormycosis and entomophthoramycosis (zygomycosis) and nomenclature of the disease: molecular mycologic perspectives. Clin Infect Dis. 2012 Feb. 54 Suppl 1:S8-S15. [Medline]. [Full Text].

  2. Rammaert B, Lanternier F, Zahar JR, et al. Healthcare-associated mucormycosis. Clin Infect Dis. 2012 Feb. 54 Suppl 1:S44-54. [Medline].

  3. Kontoyiannis DP, Wessel VC, Bodey GP, et al. Zygomycosis in the 1990s in a tertiary-care cancer center. Clin Infect Dis. 2000 Jun. 30(6):851-6. [Medline].

  4. Rippon JW. Zygomycosis. Wonsiewicz M, ed. Medical Mycology. The Pathogenic Fungi and the Pathogenic Actinomycetes. 3rd ed. Philadelphia, Pa: W.B. Saunders; 1998. 681-713.

  5. Greenberg RN, Scott LJ, Vaughn HH, et al. Zygomycosis (mucormycosis): emerging clinical importance and new treatments. Curr Opin Infect Dis. 2004 Dec. 17(6):517-25. [Medline].

  6. Kauffman CA. Zygomycosis: reemergence of an old pathogen. Clin Infect Dis. 2004 Aug 15. 39(4):588-90. [Medline].

  7. Kontoyiannis DP, Azie N, Franks B, Horn DL. Prospective antifungal therapy (PATH) alliance(®) : focus on mucormycosis. Mycoses. 2014 Apr. 57 (4):240-6. [Medline].

  8. Ribes JA, Vanover-Sams CL, Baker DJ. Zygomycetes in human disease. Clin Microbiol Rev. 2000 Apr. 13(2):236-301. [Medline].

  9. Gonzalez CE, Rinaldi MG, Sugar AM. Zygomycosis. Infect Dis Clin North Am. 2002 Dec. 16(4):895-914, vi. [Medline].

  10. Petrikkos G, Skiada A, Lortholary O, Roilides E, Walsh TJ, Kontoyiannis DP. Epidemiology and clinical manifestations of mucormycosis. Clin Infect Dis. 2012 Feb. 54 Suppl 1:S23-34. [Medline].

  11. Roden MM, Zaoutis TE, Buchanan WL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis. 2005 Sep 1. 41(5):634-53. [Medline].

  12. Binder U, Maurer E, Lass-Flörl C. Mucormycosis--from the pathogens to the disease. Clin Microbiol Infect. 2014 Jun. 20 Suppl 6:60-6. [Medline].

  13. Lanternier F, Sun HY, Ribaud P, Singh N, Kontoyiannis DP, Lortholary O. Mucormycosis in organ and stem cell transplant recipients. Clin Infect Dis. 2012 Jun. 54(11):1629-36. [Medline].

  14. Tacke D, Koehler P, Markiefka B, Cornely OA. Our 2014 approach to mucormycosis. Mycoses. 2014 Sep. 57 (9):519-24. [Medline].

  15. Walsh TJ, Gamaletsou MN, McGinnis MR, Hayden RT, Kontoyiannis DP. Early clinical and laboratory diagnosis of invasive pulmonary, extrapulmonary, and disseminated mucormycosis (zygomycosis). Clin Infect Dis. 2012 Feb. 54 Suppl 1:S55-60. [Medline].

  16. Thomson SR, Bade PG, Taams M, et al. Gastrointestinal mucormycosis. Br J Surg. 1991 Aug. 78(8):952-4. [Medline].

  17. Lass-Flörl C, Resch G, Nachbaur D, Mayr A, Gastl G, Auberger J, et al. The value of computed tomography-guided percutaneous lung biopsy for diagnosis of invasive fungal infection in immunocompromised patients. Clin Infect Dis. 2007 Oct 1. 45(7):e101-4. [Medline].

  18. Chamilos G, Lewis RE, Kontoyiannis DP. Delaying amphotericin B-based frontline therapy significantly increases mortality among patients with hematologic malignancy who have zygomycosis. Clin Infect Dis. 2008 Aug 15. 47(4):503-9. [Medline].

  19. Miceli MH, Kauffman CA. Isavuconazole: A New Broad-Spectrum Triazole Antifungal Agent. Clin Infect Dis. 2015 Jul 15. [Medline].

  20. Ananda-Rajah MR, Kontoyiannis D. Isavuconazole: a new extended spectrum triazole for invasive mold diseases. Future Microbiol. 2015. 10 (5):693-708. [Medline].

  21. Lewis RE, Lortholary O, Spellberg B, Roilides E, Kontoyiannis DP, Walsh TJ. How does antifungal pharmacology differ for mucormycosis versus aspergillosis?. Clin Infect Dis. 2012 Feb. 54 Suppl 1:S67-72. [Medline].

  22. Spellberg B, Ibrahim A, Roilides E, et al. Combination therapy for mucormycosis: why, what, and how?. Clin Infect Dis. 2012 Feb. 54 Suppl 1:S73-8. [Medline].

  23. Huang AM, Nagel JL, Crass RL, Nguyen C. Combination Therapy for the Treatment of Mucormycosis: Examining the evidence. Curr Fungal Infect Resp. 2015. 9:94-110.

  24. Sun QN, Fothergill AW, McCarthy DI, et al. In vitro activities of posaconazole, itraconazole, voriconazole, amphotericin B, and fluconazole against 37 clinical isolates of zygomycetes. Antimicrob Agents Chemother. 2002 May. 46(5):1581-2. [Medline].

  25. Dannaoui E, Meletiadis J, Mouton JW, et al. In vitro susceptibilities of zygomycetes to conventional and new antifungals. J Antimicrob Chemother. 2003 Jan. 51(1):45-52. [Medline].

  26. Herbrecht R. Posaconazole: a potent, extended-spectrum triazole anti-fungal for the treatment of serious fungal infections. Int J Clin Pract. 2004 Jun. 58(6):612-24. [Medline].

  27. van Burik JA, Hare RS, Solomon HF, Corrado ML, Kontoyiannis DP. Posaconazole is effective as salvage therapy in zygomycosis: a retrospective summary of 91 cases. Clin Infect Dis. 2006 Apr 1. 42(7):e61-5. [Medline].

  28. Reed C, Bryant R, Ibrahim AS, et al. Combination polyene-caspofungin treatment of rhino-orbital-cerebral mucormycosis. Clin Infect Dis. 2008 Aug 1. 47(3):364-71. [Medline]. [Full Text].

  29. Ibrahim AS, Edwards JE, Filler SG, Spellberg B. Mucormycosis and Entomophthoramycosis (Zygomycosis). Kauffman CA, Pappas PG, Sobel JD, Dismukes WE, eds. Essentials of Clinical Mycology. 2nd ed. New York, NY: Springer; 2011. 265-80.

  30. Katragkou A, McCarthy M, Meletiadis J, Petraitis V, Moradi PW, Strauss GE, et al. In vitro combination of isavuconazole with micafungin or amphotericin B deoxycholate against medically important molds. Antimicrob Agents Chemother. 2014 Nov. 58 (11):6934-7. [Medline].

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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