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At least 19 recordsLinked to original sources

PubMed2026

Rapid and reliable diagnosis of mucormycosis using colorimetric loop-mediated isothermal amplification.

Current diagnostic approaches for mucormycosis are often limited by low sensitivity and prolonged turnaround times, which result in delayed treatment and poor clinical outcomes. We developed a novel diagnostic method utilizing a colorimetric loop-mediated isothermal amplification (LAMP) assay for the rapid and sensitive detection of mucormycosis. The assay incorporates specifically designed primers capable of detecting as low as 0.001 picograms (pg) of spiked genomic DNA from Mucorales fungi. This LAMP assay demonstrated a high sensitivity of 98% and a 100% specificity of detecting fungal ribosomal DNA (rDNA) in bronchoalveolar lavage (BAL) samples collected from mice infected with Mucorales fungi (n = 48) or from an uninfected control group (n = 15). To align the assay with clinical antifungal therapy, a subset of infected mice was treated with either liposomal amphotericin B (LAMB) or a combination of LAMB and a humanized monoclonal antibody (VX-01) targeting the Mucorales-specific surface protein CotH3. Consistent with the treatment efficacy, the LAMP assay detected significantly lower fungal burdens in BAL samples from mice receiving the combination therapy compared to those treated with LAMB alone or placebo. Further validation was conducted using BAL samples from patients diagnosed with mucormycosis (n = 24) or aspergillosis (n = 17). The assay demonstrated a sensitivity of 79% and a specificity of 94%. These findings highlight the diagnostic potential of this LAMP-based assay as a point-of-care. Its high sensitivity, specificity, and rapid turnaround time position this assay as a promising tool for early and accurate detection of mucormycosis, with the potential to improve patient management and clinical outcomes.IMPORTANCEMucormycosis is a rapidly progressive and fatal fungal infection. Timely diagnosis is critical for effective treatment, yet current diagnostic tools are slow, insensitive, or require complex laboratory procedures. In this study, we developed and validated a colorimetric loop-mediated isothermal amplification (LAMP) assay that enables rapid and reliable detection of Mucorales DNA directly from bronchoalveolar lavage (BAL) specimens. The assay demonstrated high sensitivity and specificity in both experimental mouse models and clinical samples, producing results within 1 h without the need for sophisticated equipment. This simple, robust, and cost-effective molecular diagnostic tool holds great potential for early detection of mucormycosis, facilitating prompt antifungal therapy and improving patient survival.

Mucormycosis↗

PubMedDate not supplied

Localized mucormycosis following intramuscular corticosteroid. Case report and review of the literature.

A case of subcutaneous localized mucormycosis infection which developed following intramuscular (IM) injection of corticosteroid in a patient with leukemia is presented. Aggressive treatment, which included wide local excision, systemic amphotericin-B, and chemotherapy for the leukemia, resulted in eradication of the infection and complete healing of the wound. A review of the literature revealed nine other patients with the localized subcutaneous form of mucormycosis (excluding patients with burns and rhinocerebral types) and six of those nine patients also survived the infection. It is possibly the mildness of the underlying predisposing factors that allows some of these patients to contain the infection at a single site. It is apparent from review of the literature that in subcutaneous localized forms of mucormycosis, the outcome has been generally good. This contrasts sharply with other clinical forms of mucormycosis infections where the underlying predisposing factors are usually severe and any kind of therapeutic approach has been almost always futile. Subcutaneous mucormycosis infection differs clinically and histopathologically from subcutaneous localized entomophthoromycosis which is seen predominantly in tropical countries. An attempt is made to clarify the terminology of these interesting fungi in language that is taxonomically up-to-date and still useful to clinicians.

Adult↗

PubMed1979

Acute subdural hematoma and intracerebral hemorrhage. Rare complications of rhinocerebral mucormycosis.

Rhinocerebral mucormycosis is a short-term and often rapidly lethal fungal disease. It is generally seen in uncontrolled cases of diabetes with ketoacidosis. This case exhibits many of the features of a typical fulminating rhinocerebral mucormycosis. However, the fatal complications of acute subdural hematoma and massive intracerebral hemorrhage due to rupture of aneurysm, as demonstrated by angiography, are unique clinical manifestations of patients with rhinocerebral mucormycosis.

Antifungal Agents↗

PubMed1975

Mucormycosis in a transplant recipient.

Mucormycosis classically occurs in patients who have uncontrolled diabetes who develop rhinocerebral disease. A fatal case of rhinocerebral infection caused by Rhizopus arrhizus in a 53-year-old man who had received a renal homograft three years previously is reported. Only five similar cases have been documented, all since 1970. Although direct smears of the purulent nasal exudate revealed the presence of numerous Gram-negative bacilli, later identified as Haemophilus influenzae, the diagnosis of mucormycosis was made by demonstrating the typical broad, nonseptate branched hyphae in the necrotic tissue obtained by surgical debridement of the paranasal sinuses. Culture of this material revealed growth of mold-like fungus which, upon direct microscopic examination, showed sporangiophores bearing spherical sporangia arising directly from a cluster of root-like structures of rhizoids. Despite the immediate institution of therapy with amphotericin B postoperatively, the patient died 48 hours later. Subsequently, the Rhizopus isolated was shown to be resistant to both amphotericin B and 5-fluorocytosine. The present case and two others stress the importance of an aggressive diagnostic approach to patients suspected of having mucormycosis, because the usual microbiologic technics are frequently, inexplicably, unsuccessful, and possibly even misleading in this disease.

Adult↗

PubMed1992

Indolent orbital apex syndrome caused by occult mucormycosis.

The chronic or indolent presentation of rhino-orbital mucormycosis, as defined by the presence of symptoms for more than 1 month before diagnosis, is extremely unusual. A 45-year-old man with stable diabetes presented with a right orbital apex syndrome and minimal ethmoid and sphenoid sinusitis. Progression was indolent, and the diagnosis was not made until 7 weeks after admission, when a third biopsy was prompted by new cavernous sinus and carotid artery thromboses. Mucormycosis was found. The patient improved on amphotericin B (2 g) and strict blood glucose control. A remarkable aberrant regeneration of the right oculomotor nerve was seen following treatment. He remains free of active disease 4 years later. Orbital symptoms in well-controlled diabetics, which may even remain stable for weeks and lack direct signs of tissue invasion, should raise the suspicion of mucormycosis.

Carotid Artery Thrombosis↗

PubMed1979

Rhinocerebral mucormycosis: premortem diagnosis and therapy.

The diagnosis of rhinocerebral mucormycosis is most often made at autopsy. We report a series of nine patients in whom the diagnosis was established premortem. Six of the patients had underlying diabetes mellitus and three had acute leukemia. Facial or ocular pain was the complaint found in all patients, and frequently was the initial symptom. The diagnosis was established by examination and culture of infected tissue obtained by biopsy. In seven patients, identification of hyphal elements in smears of biopsy material allowed the immediate institution of amphotericin B therapy. Four of the seven patients treated with amphotericin B survived. All surviving patients had underlying diabetes mellitus and had undergone surgical debridement. Early diagnosis leading to immediate institution of appropriate therapy is most important for survival of patients with mucormycosis.

Acute Disease↗

PubMed1979

Cerebral mucormycosis: an unusual case.

A 36-year-old obese woman with hyperglycemia and immunosuppression died of bilateral internal carotid artery occlusion associated with mucormycosis. This report describes a rare case in which cerebral mucormycosis occurred without the usual preceding clinical evidence of nasal and orbital infection.

Adult↗

PubMed1977

Rhinocerebral mucormycosis.

Mucormycosis is a fulminant fungal infection occurring in debilitated patients with an underlying pathologic condition. The rhinocerebral form of the disease, which comprises nearly one half of recently reported cases, is most often found in uncontrolled diabetics or profoundly dehydrated children. Infection usually begins in the nose and progresses through the paranasal sinuses, invading the orbit and CNS secondarily. Despite the known pathogenesis of this disease, the ophthalmologist is often first to consider the diagnosis, due to inadequate intranasal examination by the primary physician. The delay caused by late occurrence of orbital manifestations has resulted in poor survival rates, despite vigorous therapy. In recent years, increased physician awareness has led to earlier diagnosis of rhinocerebral mucormycosis. This report presents 13 cases with which we have delt since 1963. The long-term survival rate is 85%. Aggressive surgical therapy, with repeated debridement, in combination with intravenous amphotericin B, have led to this high rate of cure.

Acidosis↗

PubMed1975

Rhinocerebral mucormycosis: diagnosis and treatment. Report of two cases.

Rhinocerebral mucormycosis (phycomycetes), a human fungal disease with oral and perioral findings, has an extremely high morbidity and mortality. The disease is most frequently seen in patients with poorly controlled diabetes. The symptoms, findings, and treatment of rhinocerebral mucormycosis are discussed, and two case histories are presented.

Adult↗

PubMed1979

Rhizopus rhizopodiformis: emerging etiological agent of mucormycosis.

Mucormycosis is caused principally by members of the genus Rhizopus, especially R arrhizus and R. oryzae. Infection attributable to R. rhizopodiformis has rarely been documented. Of 13 cases of mucormycosis diagnosed during a 4-year period (1974 to 1978) at The Mount Sinai Hospital, 6 cases, occurring within 9 months, were caused by R. rhizopodiformis. The six isolates were identified mainly by: growth at 50 degrees C; production of short, sometimes branched, sporangiophores arising from opposite rhizoids; elongated columellae; and small spherical-to-elliptical, smooth-to-finely striated sporangiospores. The possibility that this explosive occurrence of R. rhizopodiformis at our institution was because of nosocomial acquisition was strongly supported by the recovery of this same mycotic agent from adhesive bandages used in the cardiac intensive care unit, where a patient developed subcutaneous R. rhizopodiformis infection after cardiac surgery. The invasive potential of R. rhizopodiformis was manifested by the extensive subcutaneous and systemic infections in each of the six patients, three of whom developed antibody against this mucormycotic agent.

Adult↗

PubMed1975

Rhinocerebral mucormycosis.

Nine cases of rhinocerebral mucormycosis are reviewed. Eight patients had diabetes and 7 had symptoms related to the orbit. Roentgen analysis of focal bone destruction and uniform mucosal thickening will frequently suggest the diagnosis. Mucormycosis should be suspected in the diabetic patient with destruction of the walls of the bony sinuses, especially when multiple sinus involvement suggests an etiology other than neoplasm.

Adolescent↗

PubMed2025

Hematological diseases-related mucormycosis: A retrospective single center study.

BACKGROUND AND AIM: Mucormycosis is a life-threatening invasive fungal infection. This study aimed to analyze the clinical characteristics of patients with hematologic malignancies complicated with mucormycosis. METHODS: This retrospective study investigated the clinical characteristics, epidemiological features, treatment, and prognosis of 46 patients with hematological diseases and Mucor infection as indicated by mNGS from August 28, 2020 to September 11, 2023. Metagenomic next-generation sequencing (mNGS) refers to the application of high-throughput sequencing technology for the comprehensive analysis of nucleic acid content in patient samples, facilitating the detection and characterization of microbial DNA and/or RNA, and then comparing and analyzing the results with an information database to determine the types of pathogenic microorganisms present in the sample. RESULTS: The median age of admission for the included patients was 49 years (9-78). Multivariate analysis identified age over 60 years (p = 0.006 < 0.05), high-dose corticosteroids (p = 0.001 < 0.05), neutropenia lasting more than 10 days (p = 0.041 < 0.05), and two or more Mucor infections (p = 0.004 < 0.05) were independent risk factors for OS in patients with hematological diseases. Moreover, differences between groups were analyzed using the Fisher exact probability method, and no significant difference was observed in the efficacy of various types of antifungal therapies. CONCLUSION: Patients with hematologic malignancies benefit greatly from early diagnosis and treatment when suspected of Mucor infection. mNGS is an important supplementary method for early diagnosis of Mucor infection. Moderated use of corticosteroids, reducing the duration of neutropenia, and enhancing autologous immune function are important measures to reduce patient mortality rate.

Retrospective Studies↗

PubMed1975

Pulmonary mucormycosis with massive fatal hemoptysis.

Abrupt, massive, and fatal hemoptysis occurred in two patients with pulmonary mucormycosis. One patient had uucontrolled diabetes mellitus and the other acute leukemia in remission. Pulmonary artery erosion by mucormycotic hyphae caused the hemorrhage cases. Mucormycosis is an unusual cause of massive hemoptysis.

Adult↗

PubMed1977

Pulmonary mucormycosis: another cure.

Pulmonary mucormycosis in an ill patient with poorly controlled chronic lymphocytic leukemia was diagnosed with open lung biopsy without excision. He improved on medical management and became ambulatory. At autopsy one year later, no residual mucormycosis was present. Better control of leukemia and more specific antimicrobial therapy are discussed as potentially important factors in patient management.

Aged↗

PubMed1977

Rhinocerebral mucormycosis.

Rhinocerebral mucormycosis is a fungal diseases that has a 50% mortality. Its occurrence has increased, possibly because of greater use of chemotherapeutic agents that mya compromise the immunologic defenses of the host or alter the normal flora. The earliest signs, ulceration and pain, may appear in the mouth. In the patient described in this report, the autopsy showed that mucormycosis had entered the brain cells.

Amphotericin B↗

PubMed1975

Head and brain scan findings in rhinocerebral mucormycosis: case report.

Brain and bone scan findings in two patients suffering from rhinocerebral mucormycosis following kidney transplantation are presented. Two patients who had had kidney transplants and were sustained for over a month on immunosuppressive drugs developed a rare type of opportunistic infection--mucormycosis. They were examined in various stages of their disease. Special attention was paid to the scintillagraphic findings.

Adult↗

PubMed1977

[Cranial mucormycosis in a patient with a transplanted kidney].

Mucormycosis is a very serious complication of debilitating diseases, and particularly of diabetes. Presently the treatment of choice is amphotericine B. A patient is described who, like most other renal transplant patients with mucormycosis, had cranial localization of this disease and diabetes. The clinical findings were classical and the diagnosis was confirmed histologically.

Adult↗

PubMed1977

Pulmonary and rhinocerebral mucormycosis. Successful outcome with amphotericin B and griseofulvin therapy.

An ominous prognosis is associated with combined pulmonary and rhinocerebral mucormycosis (phycomycosis). We report the case of a diabetic patient with ketoacidosis who had extensive pulmonary and rhinocerebral mucormycosis that responded satisfactorily to amphotericin B and griseofulvin therapy. The affected lung is completely atelectatic and has remained so for 12 months without evidence of necrosis or abscess formation.

Adult↗