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Mycoses ; 64(4): 372-380, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33253454

ABSTRACT

BACKGROUND: Mucormycosis is a rare, invasive disease associated with high mortality rates, produced by opportunistic pathogens related to the Mucorales order and characterised by a diverse range of clinical forms; acute rhino-orbital-cerebral and pulmonary symptoms are the most reported ones. OBJECTIVES: To report the experience of mucormycosis observed in a tertiary-care hospital in Mexico for 35 years. METHODS: This was a retrospective, descriptive and observational study on mucormycosis at a tertiary-care hospital in Mexico from January 1985 to December 2019. Demographic and clinical data and mycological and histopathological records were selected. RESULTS: Two hundred fourteen proven cases of mucormycosis for 35 years at a tertiary-care hospital in Mexico were included. Most of the cases were male patients with a median age of 45 years. The two most associated underlying diseases were diabetes mellitus (76.6%) and haematologic malignancy (15.4%). The three primary clinical forms were as follows: rhino-orbito-cerebral (75.9%), cutaneous (8.41%) and pulmonary (7.47%) mucormycosis. The most isolated agents were Rhizopus arrhizus (58.4%) and Lichtheimia corymbifera (12.3%). The overall therapeutic response was 58.5%, and the best response was observed with amphotericin B deoxycholate and surgical debridement. CONCLUSION: Mucormycosis is an emerging disease, and its incidence has increased at our hospital over the years. In this study, the rhino-cerebral clinical type was the most frequent in patients with uncontrolled diabetes; the main aetiological agent was R. arrhizus. Early diagnosis, control of the underlying disease and prompt management may increase the survival rate.


Subject(s)
Mucormycosis/epidemiology , Mucormycosis/mortality , Tertiary Care Centers/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Child , Child, Preschool , Deoxycholic Acid/therapeutic use , Drug Combinations , Female , Humans , Infant , Infant, Newborn , Male , Medical Records , Mexico/epidemiology , Middle Aged , Mucorales/genetics , Mucorales/pathogenicity , Mucormycosis/drug therapy , Retrospective Studies , Time Factors , Young Adult
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