[Rhinocerebral mycoses caused by Mucoraceae species (mucormycosis). Case report and literature review]

Abstract

According to the literature and on the basis of the case reported in this paper of rhinocerebral mucoraceae mycosis we summarize the characteristic features as follows: mucoraceae--mycoses--common, but wrong term: "mucormycoses"--are a group of infections caused by members of the family mucoraceae (Mucor, Rhizomucor, Rhizopus, Absidia species)--most frequently by Rhizopus species. Primarily the fungi enter the pharynx or nose, local infections or trauma being a prerequisite. The most important predisposing factor is diabetes mellitus. Invading the tissue and causing vascular thrombosis the infection frequently takes an acute, often fulminating and fatal course. Acute sinusitis accompanied by swelling of the cheek and protrusion of the eye in a diabetic, particularly with acidosis, are pathognomonic. Diagnosis is confirmed by microscopic examination of infected tissue (unstained smear or histologically). Since systemically administered antifungals have not proved very effective in these myoses, mainly because an adequate tissue level can hardly be achieved, the most effective and curative treatment is surgical removal of infected tissue, simultaneous control of diabetes being mandatory.