Mucormycosis

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Summary of Mucormycosis

Mucormycosis is any fungal infection, though usually of the sinuses and brain, caused by fungi in the order Mucorales. Mucor and Rhizopus species are most often implicated. These fungi have irregular, broad, nonseptate hyphae branching at wide angles. Diabetic patients in ketoacidosis and neutropenic patients are most at risk for the disease. The fungi proliferate in blood vessel walls, then penetrate the cribriform plate to enter the brain and cause cavernous sinus thrombosis and/or cranial nerve involvement. A black necrotic eschar is seen on the face. Treatment is with surgical debridement and amphotericin B.

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Mucormycosis

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Mucormycosis

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A 24-year-old man comes to the emergency department because of a 3-day history of fever, vomiting, headache, and facial pain. His temperature is 38.5°C (101.3°F), pulse is 84/min, respirations are 16/min, and blood pressure is 122/90 mm Hg. Physical examination shows swelling of his left eye and black lesions on the upper side of his mouth as well as a mucoid discharge from his nose. Laboratory studies show:

A CT scan shows an inflammatory process involving the nasal cavity, ethmoid cells, maxillary sinus, and orbit in the left side. A histologic section of periorbital tissue is shown below. Which of the following is the most likely causal organism?

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