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. 2024 Jul 23;11(8):ofae426.
doi: 10.1093/ofid/ofae426. eCollection 2024 Aug.

Epidemiology, Clinical Manifestations, Treatment, and Outcome of Mucormycosis: A Review of 77 Cases From a Single Center in France

Blandine Denis  1 , Matthieu Resche-Rigon  2   3 , Emmanuel Raffoux  3   4 , Anne-Marie Ronchetti  4 , Emmanuel Dudoignon  3   5 , Benjamin Verillaud  6 , Sandrine Valade  7 , Gwenaël Lorillon  8 , Florence Rabian  9 , Aliénor Xhaard  10 , Sophie Touratier  11 , Samia Hamane  12 , Alexandre Alanio  12   13 , Nathalie De Castro  1   3
Affiliations

Epidemiology, Clinical Manifestations, Treatment, and Outcome of Mucormycosis: A Review of 77 Cases From a Single Center in France

Blandine Denis et al. Open Forum Infect Dis. .

Abstract

Background: The aim of this study was to assess the epidemiology, clinical manifestations, and outcome of mucormycosis over 15 years in a single center in France.

Methods: We conducted a retrospective analysis of all mucormycosis cases in our institution from 1 January 2006 to 31 December 2020 and analyzed patients' medical records, laboratory results, and treatment to describe the epidemiology, clinical manifestations, diagnosis, treatment, and outcome. Mucorales quantitative polymerase chain reaction (qPCR) for the diagnosis was implemented in 2015.

Results: Seventy-seven mucormycosis cases were analyzed in 77 patients, with a median age of 54 years (60% male). Identified risk factors were hematological diseases (46 cases [60%]), solid malignancies (2 cases), solid organ transplants (3), burns (18), diabetes only (7), and trauma (1). Sites of infection were lungs (42%), sinus (36%), skin (31%), central nervous system (9%), liver (8%), others (6%), and disseminated (12%). Diagnosis remained difficult and qPCR contributed to mucormycosis diagnosis in 30% of cases. Among hematology patients, serum qPCR was the only positive test in 15% of cases. A mixed mold infection was diagnosed in 24 of 77 (31%) patients. Surgical treatment was undertaken in 43 (56%) cases. Most patients received liposomal amphotericin B (89%), with a combination therapy in 18 of 77 cases (23%). Three-month survival rate was 40% (95% confidence interval [CI], .30-.53]). As for treatment, adjunction of surgery (hazard ratio, 0.47 [95%CI, .25-.91); P = 0.02) was associated with lower mortality.

Conclusions: Mucormycosis remained associated with high mortality, especially in the hematological and burn populations. Surgery in combination with antifungal treatment was associated with improved survival.

Keywords: diagnosis; epidemiology; immunosuppressed; mucormycosis; outcome.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts.

Figures

Figure 1.
Figure 1.
Number of mucormycosis cases reported per year at Saint-Louis Hospital between 1 January 2006 and 31 December 2020. Abbreviation: qPCR, quantitative polymerase chain reaction.
Figure 2.
Figure 2.
Overall survival after mucormycosis diagnosis.
Figure 3.
Figure 3.
Differences between hematologic–oncologic–solid organ transplantation (hemato-onco-SOT)/burn/other patients on overall survival after mucormycosis diagnosis.
See this image and copyright information in PMC

References

    1. Miller MA, Molina KC, Gutman JA, et al. . Mucormycosis in hematopoietic cell transplant recipients and in patients with hematological malignancies in the era of new antifungal agents. Open Forum Infect Dis 2020; 8:ofaa646. - PMC - PubMed
    1. Jeong W, Keighley C, Wolfe R, et al. . The epidemiology and clinical manifestations of mucormycosis: a systematic review and meta-analysis of case reports. Clin Microbiol Infect 2019; 25:26–34. - PubMed
    1. Roden MM, Zaoutis TE, Buchanan WL, et al. . Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis 2005; 41:634–53. - PubMed
    1. Littlehales E, Teague R, Andrew D, Yassaie E. Mucormycosis in burns: a review. J Burn Care Res 2022; 43:353–60. - PubMed
    1. Spellberg B, Edwards J Jr, Ibrahim A. Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev 2005; 18:556–69. - PMC - PubMed