Mucormycosis Management

Mucormycosis is an aggressive infection with high mortality caused by a group of fungi called Mucorales. The disease is often observed among individuals with underlying diseases such as poorly controlled diabetes mellitus (DM), immunocompetent subjects following trauma, and primarily in severely immunocompromised hosts (hematological malignancies, organ transplantation, neutropenia, autoimmune disorders, or other impairments in immunity). Accordingly, less than 10% of mucormycosis cases have been reported in individuals without underlying diseases. The infection could be classified into six types: rhino-orbital-cerebral mucormycosis, pulmonary, cutaneous, gastrointestinal, disseminated, and mucormycosis of uncommon sites. Rhino-orbital-cerebral mucormycosis is the most common clinical presentation in patients with DM, and lung involvement introduces the uncommon type of mucormycosis. Histopathological examination is the only definitive way to diagnose this disease. Surgical debridement followed by the administration of lipid formulations of amphotericin B (LFAB) is the first-line therapy for mucormycosis. Salvage therapy with posaconazole (POSA) and isavuconazole (ISAV) has been recommended for patients refractory to or intolerant to common treatment. Here, current management strategies and techniques of mucormycosis have been discussed. Additional studies should be performed in the field of medication monitoring, antifungal drug susceptibility testing, and factors affecting patient outcomes to help guide therapy.