This document summarizes mucormycosis, a fungal infection caused by fungi in the order Mucorales. It most commonly affects immunocompromised individuals. There are several forms including rhinocerebral, pulmonary, gastrointestinal, cutaneous, and disseminated. Rhinocerebral mucormycosis is the most common type and affects diabetic patients, presenting with nasal stuffiness and black eschar on nasal tissues. Diagnosis involves biopsy and imaging. Treatment involves controlling underlying conditions, antifungal therapy such as amphotericin B, and surgical debridement of infected tissues.

1. SEMINAR ON
MUCORMYCOSIS
by
falak naaz
pharm d intern
170310820023

2.  MUCOR MYCOSIS REFERSTO……
infection caused by fungi in order of
mucorales .
 Most common species are…rhizopus (m
c),rhizomucor,cunninghamella,apophysomy
ces,saksenaea,absidia,muccor,andsyncephal
astrum.

3. MUCORMYCOSIS
 Caused by fungi of the Rhizopus and Mucor
species, which are ubiquitous saprophytic
organisms, not uncommonly infecting the
immunocompromised host.
 These fungi have a predilection to invade
blood vessels ,causing infarction and
necrosis.

4. MUCORMYCOSIS
Rhizopus spMucor species

5. MAJOR ROUTE OF INFECTION
 INHALTION.
 INGESTION.
 TRAUMATIC INOCULTION.

6. Pathophysiology
 Angioinvasion
 Vessel thrombosis
 Tissue necrosis

7. EPIDEMIOLOGY
 INTERNATIONALY 1% PATIENTSWITH LOW
IMMUNITY.
 MUCOR MYCOSIS CARRIES AVERY HIGH
MORTALITY (50%-85%).
 NO RACIAL FACTORS PREDISPOSE.
 SEX IS NOT LIKELYTO AFFECT.

8. MUCORMYCOSIS CLINICAL
PRESNTATION
 Five clinical forms of mucormycosis :
Rhinocerebral ,pulmonary ,gastrointestinal
, primary cutaneouse and disseminated.
 Rhinocerebral type has the highest
frequency and mortality.

9. RELATIONSHIP BETWEEN
PREDISPOSING FACTORS AND SITE
OF INFECTION
 DIABETIC KETOACIDISIS- RHINOCEREBRAL.
 NEUTROPENIA- PULMONARY & DISSEMINATED.
 STEROIDS-
PULMONARY,RHINOCEREBRAL,DISSEMINATED.
 MALNUTRION-G ITRACT
 TRAUMA,CATHETER,SKIN MACERATION-
CUTANEOUS/ SUBCUTANEOUS
 DEFEROXAMINE-DISSEMINATED

10. RHINOCEREBRAL MUCORMYCOSIS
 50% of cases occur in patients with DM.
 50%CASES OFTOTAL CASES OF MUCOR
MYCOSIS.
 Usually occurs during an episode of DKA ,
with disruption of host defense mechanisms
,thereby permitting growth of Rhizopus
oryzae. Such growth is inhibited by correction
of acidosis.

11. RHINOCEREBRAL MUCORMYCOSIS
Clinical features
 Onset with nasal stuffiness ,epistaxis and
facial pain.
 Later ,proptosis , chemosis and
ophthalmoplegia.
 Fever and confusion.
 Black necrotic eschar on the nasal
turbinates or palate : very characteristic

12. RHINOCEREBRAL MUCORMYCOSIS
Complications
 Cavernous sinus thrombosis.
 Multiple cranial nerve palsies.
 Visual loss.
 Frontal lobe abscess.
 Carotid artery or jugular vein thrombosis
causing hemiparesis.

13. RHINOCEREBRAL MUCORMYCOSIS

14. RHINOCEREBRAL MUCORMYCOSIS
Diagnosis
 Punch biopsy of the lesion followed by fungal
stains and culture.
 Histological examination reveals the
characteristic broad , branching hyphae of
Rhizopus invading the tissue.
 CT or MRI of the head reveal air-fluid level in
the sinuses and involvement of deep tissues

15. RHINOCEREBRAL MUCORMYCOSIS

16. Imaging
CT scan coronal cut (posterior)
of nose and paranasal sinuses
showing heterodense mass arising
from right maxillary sinus eroding
the medial wall of maxilla and
presenting inside the nasal cavity.
The same mass could also be
seen eroding the right side of hard
palate.

17. PULMONARY MUCORMYCOSIS
 SEEN MOST COMMONLY IN –
NEUTROPENIA,PATEINTSON
CHEMOTHERPY,LEUKEMIA.
 DYSPONEA ,COUGH& CHEST PAIN &FEVER
 RADIOLOGICALY-
CONSOLIDATION,ISOLATED
MASSES,CAVITAION,WEDGE SHAPED
INFARCTS.
 CT SCAN BEST METHODTO DETECTTHE
EXTENT.

19. CUTANEOUS MUCORMYCOSIS
 TRAUMA ISTHE PREDISPOSING FACTOR.
 INVASIVE LOCALLY .
 MAY LEADTO NECROTIZING FASCITES
…MORTALITY UPTO 80%.
 SURGICAL DEBRIDEMENT.

21. GASTROINTESTINAL MUCORMYCOSIS
 RARE,,OCCURS IN EXTREMALY
MALNOURISHED,CHILDREN.
 STOMACH,COLON&ILEUMARE MOST
COMMONLY INVOLVED.
 ABDOMINAL PAIN,NAUSEAVOMITING,
,,,MAY PRESNTAS INTRAABDOMINAL
ABSCESS,OR PERFORATIONOFTHE
VISCUS.NEEDS BIOPSY.
 PROGNOSISVERY POOR

23. DISSEMINATED MUCORMYCOSIS
 HEAMATOGENOUSLY
 PULMONARY MUCORMYCOSIS HAS
HIGHEST INCIDENCE OF DISSEMINATION.
 MOST COMMON SITE OF DISSEMINATION-
BRAIN ,,,SPLEEN ,HEART,SKIN,AND OTHER
ORGANS.
 BRAIN -100%,OTHERS->90%

25. MISCALLANEOUS FORMS
 ENDOCARDITIS,PYELONEPHRITIS-IN IV
DRUG USERS.
 BONES,MEDIASTINUM,KIDNEYS,PERITONE
UM.IN PATIENTSWITH DIALYSIS

26. SOME COMMON DD S
 ANTHRAX
 ASPERGELLOSIS
 CELLULITIS
 COLONIC OBSTRUCTION
 PULMONARY EMBOLISM

27. MUCORMYCOSIS WORKUP
 BIOPSY-OF INVOLVEDTISSUE.
 SWABS OFTISSUE DISCHARGEARE
UNRELIABLE.
 CBC FOR NEUTROPENIA
 ABGTO CORRECTACIDOSIS
 RBS-SUGAR CONTROL

28. IMAGING STUDIES
 PLAIN X-RAY
 CT SCAN
 MRI SCANS
 CHEST CT/MRI

29. OTHER STUDIES
 CSF EXAMINATION
 BRONCHOALVEOLAR LAVAGE

30. THANKYOU