Mucormycosis history and symptoms

Mucormycosis Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]

Overview

Signs and symptoms of mucormycosis differ according to the organ system involvement. Severe infection of the facial sinuses, which may extend into the brain, is the most common presentation leading to proptosis, redness of skin above sinuses, mental status changes, dark scabbing in nasal cavities, fever and headache. Pulmonary mucormycosis may lead to development of cough, hemoptysis with or without chest pain and fever. Gastrointestinal mucormycosis presents as abdominal pain, hematemesis, diarrhea or constipation.

History

Obtaining history is an important factor in making a diagnosis of mucormycosis since the signs and symptoms may be non-specific and mimic other conditions with similar presentations. Most mucormycosis infections are life-threatening, and develop in the presence of other risk factors such as diabetic ketoacidosis and neutropenia. Severe infection of the facial sinuses, which may extend into the brain, is the most common presentation. Pulmonary, cutaneous, and gastrointestinal (GI) infections are also recognized.

Common Symptoms

Symptoms of rhinocerebral mucormycosis include:

• Eyes that swell and stick out (protrude)
• Dark scabbing in nasal cavities
• Fever
• Headache
• Mental status changes
• Redness of skin above sinuses
• Sinus pain or congestion

Symptoms of lung (pulmonary) mucormycosis include:

• Cough
• Hemoptysis
• Fever
• Shortness of breath

Symptoms of gastrointestinal mucormycosis include:

• Abdominal pain
• Blood in the stools
• Diarrhea
• Vomiting blood
• Inability to pass stools

Symptoms of kidney (renal) mucormycosis include:

• Fever
• Pain in the upper abdomen or back
• Hemeturia

Symptoms of skin (cutaneous) mucormycosis include:

• A single, painful, hardened area of skin that may have a blackened center

Less Common Symptoms

Mucormycosis may present with atypical features and patient may have atypical signs and symptoms which include the following:

• Maxillary necrosis (The infection begins in the nose and paranasal sinuses due to inhalation of fungal spores. The infection can spread to orbital and intracranial structures either by angioinvasion. The fungus invades the arteries leading to thrombosis and occlusion that subsequently causes necrosis of bone and soft tissues)
• Ophthalmoplegia (If there is invasion of the cavernous sinus by rhinocerebral disease)
• Seizures
• Paralysis (Secondary to intracranial hemorrhage causes by cerebral invasion)
• Rhinorrhea
• Cephalea
• Palpebral edema
• Facial edema