Zygomycosis

In the primary cutaneous form, the lesions are usually painful and necrotic, with black eschar, accompanied by a fever. Patients will usually present with a history of poorly controlled diabetes or malignancy.^[8] Myocutaneous infections may lead to amputation. Pulmonary tract infections seen with lung transplant patients, who are at high risk for fatal invasive mycoses.^[9] Rhinocerebral infection is characterized by paranasal swelling with necrotic tissues. Patient may have hemorrhagic exudates (tissue fluid from lesions tinged with blood) from the nose and eyes as the fungi penetrate through blood vessels and other anatomical structures.^[10]

Causes

Pathogenic zygomycosis is caused by species in two orders: Mucorales or Entomophthorales, with the former causing far more disease than the latter.^[11] These diseases are known as "mucormycosis" and "entomophthoramycosis", respectively.^[12]

• Order Mucorales (mucormycosis)
  • Family Mucoraceae
    • Absidia corymbifera
      )
    • Apophysomyces elegans and Apophysomyces trapeziformis
      )
    • Mucor (Mucor indicus)
    • Rhizomucor (Rhizomucor pusillus)
    • Rhizopus (Rhizopus oryzae)
  • Family Cunninghamellaceae
    • Cunninghamella (Cunninghamella bertholletiae)
  • Family
    Thamnidiaceae
    • Cokeromyces (Cokeromyces recurvatus
      )
  • Family Saksenaeaceae
    • Saksenaea (Saksenaea vasiformis)
  • Family Syncephalastraceae
    • Syncephalastrum (Syncephalastrum racemosum
      )
• Order Entomophthorales (entomophthoramycosis)
  • Family Basidiobolaceae
    • Basidiobolus (Basidiobolus ranarum)
  • Family Ancylistaceae
    • Conidiobolus (Conidiobolus coronatus/Conidiobolus incongruus)

Diagnosis

Diagnosis is done with potassium hydroxide (KOH) preparation in tissue. On light microscopy, there will be broad, ribbon-like

The clinical approach to diagnosis includes radiologic, where more than ten nodules and pleural effusion are associated to pulmonary forms of the disease. In CT, a reverse halo sign is noted. Direct microscopy and histopathology, and cultures remain the gold standards for diagnoses.[15] Zygomycophyta share close clinical and radiological features to Aspergillosis. Invasive procedures such as bronchial endoscopy and lung biopsy may be necessary to confirm pulmonary diagnosis are no validated indirect tests are available. Quantitative polymerase chain reaction to detect serum DNA of the pathogen shows promise.^[16]

Treatment

The condition may affect the

Due to the organisms' rapid growth and invasion, zygomycosis presents with a high fatality rate. Treatment must begin immediately with debridement of the necrotic tissue plus amphotericin B.^[10] Complete excision of the infectious tissue may be required as suspected dead tissue must be excised aggressively.^[13][18][19] In a documented case, conservative surgical drainage and intravenous amphotericin B in an insulin-dependent diabetic was proven effective in sino-orbital infection.^[20] The prognosis varies vastly depending upon an individual patient's circumstances.^[17]

Epidemiology

Zygomycosis has been found in survivors of the 2004 Indian Ocean earthquake and tsunami and in survivors of the 2011 Joplin, Missouri tornado.^[21]

Other animals

The term