Zygomycoses - urgency in diagnosis
Keywords:Zygomycoses, Diabetic Patients, Diagnostic Urgency.
Introduction: Zygomycoses is an angioinvasive infection most commonly seen in immunocompromised and diabetic patients. We undertook this study to determine the prevalence of Zygomycoses, in patients with a suspected Invasive Zygomycoses Infection in a tertiary centre and to identify the most common species isolated from culture.
Materials and Methods: A retrospective analysis was done from January 1, 2012 to December 8, 2014; the clinical data of the suspected patients and the positive cultures were collected.
Results and Discussion: A total of 50 samples of 27 patients with suspected Zygomycoses were sent during the 3 year period. In 25 of these patients, the samples sent were tissue biopsies from nasal cavity and 2 wound swabs from burns. Of these, 18 tissue biopsies of 13 patients and two wound swabs were detected positive for Zygomycetes. (2-Absidia corymbifera; 1-Rhizopus, 15-Mucor). Of the remaining 12 patients whose cultures were negative, 1â€“bacterial 1â€“bacterial sinusitis, 5-Invasive aspergillosis; 6-treated as Invasive fungal infections due to Zygomycetes as the imaging diagnostics and histopathological features favored that diagnosis. The majority of the patients (80%) were diabetic, and the two from the burn unit were under long-term treatment for chronic wound infections. Multiple diagnostic modalities must be used in view of the aggressive nature of the disease, but microbiological diagnosis remains the Gold Standard.
 M.M. Roden , T.E. Zaoutis, W.L. Buchanan et al. Epidemiology and Outcome of Zygomycosis: A Review of 929 Reported Cases. Clinical Infectious Diseases 41 (2005) 634â€“53. http://dx.doi.org/10.1086/432579.
 C.E. Gonzalez, M.G. Rinaldi and A.M. Sugar Zygomycosis. Infectious Disease Clinics of North America 16 (2002) 895â€“914. http://dx.doi.org/10.1016/S0891-5520(02)00037-5.
 R.N. Greenberg, L.J. Scott, H.H. Vaughn and J.A. Ribes Zygomycosis (mucormycosis): emerging clinical importance and new treatments. Current Opinion in Infectious Diseases 17 (2004) 517â€“25. http://dx.doi.org/10.1097/00001432-200412000-00003.
 C.A. Kauffman. Zygomycosis: reemergence of an old pathogen. Clinical Infectious Diseases 39 (2004) 588â€“90. http://dx.doi.org/10.1086/422729.
 R.M. Prabhu and R.Patel. Mucormycosis and entomophthoramycosis: a review of the clinical manifestations, diagnosis and treatment. Clinical Microbiology and Infection 10 (Suppl 1) (2004) 31â€“47. http://dx.doi.org/10.1111/j.1470-9465.2004.00843.x.
 A. Paultauf Mycosis mucorina. Virchows Archiv. A, Pathological anatomy and histology 102 (1885) 543. http://dx.doi.org/10.1007/BF01932420.
 J.A.Vazquez and J.D. Sobel. Fungal infections in diabetes. Infectious Disease Clinics of North America. 9 (1995) 97â€“116.
 W.A. Limongelli, M.S. Clark, R. Saglimbene, E.Baden, J.A.Washington and A.C.Williams. Successful treatment of mucocutaneous mucormycosis after dental extractio0s in a patient with uncontrolled diabetes. Journal of Oral and Maxillofacial Surgery 33 (1975) 705â€“712.
 K.A. Marr, R.A. Carter, F. Crippa, A. Wald and L. Corey. Epidemiology and outcome of mould infections in hematopoietic stem cell transplant recipients. Clinical Infectious Diseases 34 (2002) 909â€“917. http://dx.doi.org/10.1086/339202.
 D.P. Kontoyiannis, M.S. Lionakis, R.E. Lewis, et al. Zygomycosis in a tertiary-care cancer center in the era of Aspergillus-active antifungal therapy: a case-control observational study of 27 recent cases. The Journal of Infectious Diseases 191 (2005) 1350â€“1360. http://dx.doi.org/10.1086/428780.
 J.R. Boelaert, A.Z. Fenves and J.W. Coburn. Deferoxamine therapy and mucormycosis in dialysis patients: report of an international registry. American Journal of Kidney Diseases 18 (1991) 660â€“667. http://dx.doi.org/10.1016/S0272-6386(12)80606-8.
 A. Skiada, A.H. Groll, L. Pagano, R.H. Zimmerli, O. Lortholary and G. Petrikkos. Diagnosis and treatment of zygomycosis: guidelines from the 3rd European Conference on Infections in Leukemia (ECIL 3) Haematologica 98(4) (2013) 492-504. http://dx.doi.org/10.3324/haematol.2012.065110.
 D. Neofytos, D. Horn, E. Anaissie, et al. Epidemiology and outcome of invasive fungal infection in adult hematopoietic stem cell transplant recipients: analysis of Multicenter Prospective Antifungal Therapy (PATH) Alliance registry. Clinical Infectious Diseases 48 (2009) 265-273. http://dx.doi.org/10.1086/595846.
 M.J. Ruping, W.J. Heinz, A.J. Kindo, et al. Forty-one recent cases of invasive zygomycosis from a global clinical registry. Journal of Antimicrobial Chemotherapy 65 (2010) 296-302. http://dx.doi.org/10.1093/jac/dkp430.
 A. Chakrabarti, S.S. Chatterjee, A. Das, et al. Invasive zygomycosis in India: experience in a tertiary care hospital. Postgraduate Medical Journal 85 (2009) 573-581. http://dx.doi.org/10.1136/pgmj.2008.076463.
 D.P. Kontoyiannis, V.C.Wessel, G.P. Bodey and K.V. Rolston. Zygomycosis in the 1990s in a tertiary-care cancer center. Clinical Infectious Diseases 30 (2000) 851â€“856. http://dx.doi.org/10.1086/313803.
 J.A. Ribes, C.L. Vanover-Sams and D.J. Baker. Zygomycetes in human disease. Clinical Microbiology Reviews 13 (2000) 236â€“301. http://dx.doi.org/10.1128/CMR.13.2.236-301.2000.
LicenseAuthors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under aÂ Creative Commons Attribution Licensethat allows others to share the work with an acknowledgement of the work''s authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal''s published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeÂ The Effect of Open Access).