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
Review
. 2022 Feb 16;8(2):194.
doi: 10.3390/jof8020194.

Global Cutaneous Mucormycosis: A Systematic Review

Anna Skiada  1 , Maria Drogari-Apiranthitou  2 , Ioannis Pavleas  3 , Eirini Daikou  1 , George Petrikkos  2   4
Affiliations
Review

Global Cutaneous Mucormycosis: A Systematic Review

Anna Skiada et al. J Fungi (Basel). .

Abstract

Cutaneous mucormycosis is the third most common clinical type of mucormycosis. The signs and symptoms vary widely, and it is important to make the diagnosis as early as possible in order to achieve a better outcome. We present a systematic review of its epidemiology, clinical presentation, diagnosis, and treatment, analyzing cases published from 1958 until 2021. The review was conducted according to the PRISMA guidelines and included 693 cases from 485 articles from 46 countries. Most publications were from North America (256 cases, 36.9%) and Asia (216 cases, 31.2%). The most common risk factors were diabetes mellitus (20%) and hematological malignancies (15.7%). However, a large proportion of published cases (275, 39.6%) had no identified underlying disease. The most common mode of transmission was trauma (54%), and 108 (15.6%) cases were healthcare-associated. In this review, 291 (42.5%) patients had localized infection, and 90 (13%) had disseminated mucormycosis. In Europe, N. America and S. America, the most common genus was Rhizopus spp., while in Asia it was Apophysomyces spp. (34.7%). Treatment was performed with antifungals, mainly amphotericin B, and/or surgery. Mortality was significantly lower when both antifungals and surgery were applied (29.6%).

Keywords: cutaneous; epidemiology; mucormycosis; review; trauma; zygomycosis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA diagram describing the identification of eligible cases.
Figure 2
Figure 2
Cases of cutaneous mucormycosis per year from 1958 to 30 June 2021.
Figure 3
Figure 3
Geographic distribution of cases. Countries in the figure had at least four cases. The rest were: Thailand, Qatar, and Argentina had three cases each; Tunisia, Singapore, S. Korea, Poland, and Czech Republic had two cases each; Sweden, Portugal, Finland, Lithuania, Guatemala, Ecuador, Sri Lanka, Oman, Nepal, Kuwait, and South Africa had one case each.
Figure 4
Figure 4
Anatomic site of infection.
Figure 5
Figure 5
Geographic distribution of causative Mucorales organisms. Two cases were from Tunisia, Africa, and are not included in the Figure. * All Mucor species except Mucor irregularis.
See this image and copyright information in PMC

References

    1. Roden M.M., Zaoutis T.E., Buchanan W.L., Knudsen T.A., Sarkisova T.A., Schaufele R.L., Sein M., Sein T., Chiou C.C., Chu J.H., et al. Epidemiology and out-come of zygomycosis: A review of 929 reported cases. Clin. Infect. Dis. 2005;41:634e53. doi: 10.1086/432579. - DOI - PubMed
    1. Jeong W., Keighley C., Wolfe R., Lee W.L., Slavin M.A., Kong D.C., Chen S.C.-A. The epidemiology and clinical mani-festations of mucormycosis: A systematic review and meta-analysis of case reports. Clin. Microbiol. Infect. 2019;25:26–34. doi: 10.1016/j.cmi.2018.07.011. - DOI - PubMed
    1. Petrikkos G., Skiada A., Lortholary O., Roilides E., Walsh T.J., Kontoyiannis D.P. Epidemiology and Clinical Manifesta-tions of Mucormycosis. Clin. Infect. Dis. 2012;54:S23–S34. doi: 10.1093/cid/cir866. - DOI - PubMed
    1. Chakrabarti A., Das A., Mandal J., Shivaprakash M.R., George V.K., Tarai B., Rao P., Panda N., Verma S.C., Sakhuja V. The rising trend of invasive zygomycosis in patients with uncontrolled diabetes mellitus. Med. Mycol. 2006;44:335–342. doi: 10.1080/13693780500464930. - DOI - PubMed
    1. Saegeman V., Maertens J., Meersseman W., Spriet I., Verbeken E., Lagrou K. Increasing Incidence of Mucormycosis in University Hospital, Belgium. Emerg. Infect. Dis. 2010;16:1456–1458. doi: 10.3201/eid1609.100276. - DOI - PMC - PubMed

LinkOut - more resources