Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec;63(12):1264-1282.
doi: 10.1111/myc.13187. Epub 2020 Oct 3.

Epidemiology, clinical features, diagnosis and treatment of cerebral mucormycosis in diabetic patients: A systematic review of case reports and case series

Zahra Chegini  1 , Mojtaba Didehdar  2 , Amin Khoshbayan  3 , Shahin Rajaeih  4 , Mohammadreza Salehi  5 , Aref Shariati  6
Affiliations

Epidemiology, clinical features, diagnosis and treatment of cerebral mucormycosis in diabetic patients: A systematic review of case reports and case series

Zahra Chegini et al. Mycoses. 2020 Dec.

Abstract

Background: Patients with diabetes are known as an important high-risk group for cerebral mucormycosis (CM).

Method: We conducted a structured search using PubMed/MEDLINE to collect both case reports and case series case (ie including at least two patients) onto CM in diabetic patient published between 2000 and March 2020.

Results: Forty-five reports of individual cases and eighteen case series articles were included. India accounted for the largest share of reports with 37.7% and 38.8% of individual cases and case series, respectively. Mortality ranged from 0% to 100% in the case series. The overall mortality in the individual cases was 46.3%, and 64.2% of deaths were reported in patients with ketoacidosis diabetes. Facial swelling (53.3%), headache (44.4%), loss of vision (35.5%) and ophthalmoplegia (35.5%) were the most frequently reported clinical symptoms. In all patients except 4 (91.1%), CM was treated surgically; however, in many cases (42%), despite the use of surgery, death occurred. Amphotericin B deoxycholate (AMB) and lipid-based AMB (LAMB) were used as the first lines of treatment for all patients; however, posaconazole, echinocandins, hyperbaric oxygen therapy (HBOT) and deferasirox were used in combination for a number of patients. Posaconazole has been shown to have positive therapeutic effect; however, posaconazole, LAMB and HBOT are not commonly used in low-income and health-challenged countries.

Conclusion: Cerebral mucormycosis is a rapidly progressive infection in diabetic patients and carries immense morbidity despite early diagnosis and treatment. Low-income countries have had the highest number of reports of the disease in recent years, indicating the need to control diabetes in these countries.

Keywords: cerebral mucormycosis; clinical manifestations; diabetic patients; diagnosis; epidemiology; treatment.

PubMed Disclaimer

References

REFERENCES

    1. Rv S, KaRande GS, Mohite S, Patil S. Rhino-orbital mucormycosis in diabetes mellitus. J Clin Diagnos Res. 2013;7(6):1145.
    1. Gomes MZ, Lewis RE, Kontoyiannis DP. Mucormycosis caused by unusual mucormycetes, non-Rhizopus,-Mucor, and-Lichtheimia species. Clin Microbiol Rev. 2011;24(2):411-445.
    1. Prakash H, Chakrabarti A. Global epidemiology of mucormycosis. J Fungi. 2019;5(1):26.
    1. Shariati A, Moradabadi A, Chegini Z, Khoshbayan A, Didehdar M. An overview of the management of the most important invasive fungal infections in patients with blood malignancies. Infect Drug Resist. 2020;13:2329-2354.
    1. Suganya R, Malathi N, Karthikeyan V, Janagaraj VD. Mucormycosis: a brief review. J Pure Appl Microbiol. 2019;13(1):161-165.

Publication types

MeSH terms